Provider Demographics
NPI:1083143697
Name:JOHN W. ZARRELLA, D.M.D., LLC.
Entity Type:Organization
Organization Name:JOHN W. ZARRELLA, D.M.D., LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:ZARRELLA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:508-881-1280
Mailing Address - Street 1:171 MAIN STREET
Mailing Address - Street 2:100
Mailing Address - City:ASHLAND
Mailing Address - State:MA
Mailing Address - Zip Code:01721
Mailing Address - Country:US
Mailing Address - Phone:508-881-1280
Mailing Address - Fax:508-881-3529
Practice Address - Street 1:171 MAIN STREET
Practice Address - Street 2:100
Practice Address - City:ASHLAND
Practice Address - State:MA
Practice Address - Zip Code:01721
Practice Address - Country:US
Practice Address - Phone:508-881-1280
Practice Address - Fax:508-881-3529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-07
Last Update Date:2017-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAD169141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty