Provider Demographics
NPI:1093925836
Name:YURKIEWICZ, ZOFIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ZOFIA
Middle Name:
Last Name:YURKIEWICZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 BUTLER ST
Mailing Address - Street 2:
Mailing Address - City:WINDERMERE
Mailing Address - State:FL
Mailing Address - Zip Code:34786-8530
Mailing Address - Country:US
Mailing Address - Phone:407-277-1211
Mailing Address - Fax:407-380-0543
Practice Address - Street 1:1016 E HIGHWAY 50
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-3239
Practice Address - Country:US
Practice Address - Phone:352-241-4884
Practice Address - Fax:352-241-4882
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 103191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice