Provider Demographics
NPI:1093927014
Name:ZABLOTSKY, MARK H (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:H
Last Name:ZABLOTSKY
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 1:1 SCRIPPS DR
Mailing Address - Street 2:SUITE 305
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-6206
Mailing Address - Country:US
Mailing Address - Phone:916-641-1200
Mailing Address - Fax:916-641-1400
Practice Address - Street 1:1 SCRIPPS DR
Practice Address - Street 2:SUITE 305
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-6206
Practice Address - Country:US
Practice Address - Phone:916-641-1200
Practice Address - Fax:916-641-1400
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA361261223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA36126OtherDENTAL LICENSE NUMBER