Provider Demographics
NPI:1083742092
Name:ZEBARTH, STEPHEN M (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:M
Last Name:ZEBARTH
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 1:110 W CORK ST
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-4126
Mailing Address - Country:US
Mailing Address - Phone:540-722-4182
Mailing Address - Fax:540-723-2455
Practice Address - Street 1:110 W CORK ST
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-4126
Practice Address - Country:US
Practice Address - Phone:540-722-4182
Practice Address - Fax:540-723-2455
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010079511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice