Provider Demographics
NPI:1033274907
Name:ZURN, DEREK STEPHEN (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:DEREK
Middle Name:STEPHEN
Last Name:ZURN
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:574 PEAKHAM RD
Mailing Address - Street 2:
Mailing Address - City:SUDBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01776-2236
Mailing Address - Country:US
Mailing Address - Phone:978-443-0733
Mailing Address - Fax:
Practice Address - Street 1:966 PARK ST BLDG C
Practice Address - Street 2:
Practice Address - City:STOUGHTON
Practice Address - State:MA
Practice Address - Zip Code:02072-3650
Practice Address - Country:US
Practice Address - Phone:781-341-0030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX210691223P0221X
MA215711223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry