Provider Demographics
NPI:1073647723
Name:ZERO, DOMENICK THOMAS (DDS)
Entity Type:Individual
Prefix:DR
First Name:DOMENICK
Middle Name:THOMAS
Last Name:ZERO
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 1:760 EAGLE CREEK CT
Mailing Address - Street 2:
Mailing Address - City:ZIONSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46077-2003
Mailing Address - Country:US
Mailing Address - Phone:317-733-1633
Mailing Address - Fax:
Practice Address - Street 1:1121 WEST MICHIGAN ST
Practice Address - Street 2:INDIANA UNIVERSITY SCHOOL OF DENTISTRY
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202
Practice Address - Country:US
Practice Address - Phone:317-274-8822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12010340A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist