Provider Demographics
NPI:1013398304
Name:ZOMBEK, HANNA MARIE (DMD)
Entity Type:Individual
Prefix:DR
First Name:HANNA
Middle Name:MARIE
Last Name:ZOMBEK
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 KANDEMOR LN
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-3212
Mailing Address - Country:US
Mailing Address - Phone:252-443-6443
Mailing Address - Fax:252-443-0043
Practice Address - Street 1:165 KANDEMOR LN
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-3212
Practice Address - Country:US
Practice Address - Phone:252-443-6443
Practice Address - Fax:252-443-0043
Is Sole Proprietor?:No
Enumeration Date:2015-06-12
Last Update Date:2015-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice