Provider Demographics
NPI:1003997487
Name:ZWOLAK, EUGENE JULIAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:JULIAN
Last Name:ZWOLAK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 BOX CANYON CT
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48309-2328
Mailing Address - Country:US
Mailing Address - Phone:248-375-1477
Mailing Address - Fax:
Practice Address - Street 1:26730 VAN DYKE AVE
Practice Address - Street 2:
Practice Address - City:CENTER LINE
Practice Address - State:MI
Practice Address - Zip Code:48015-1224
Practice Address - Country:US
Practice Address - Phone:586-756-5858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901012571122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist