Provider Demographics
NPI:1124041033
Name:ZAPATA, JORGE FRANCISCO (DDS)
Entity Type:Individual
Prefix:
First Name:JORGE
Middle Name:FRANCISCO
Last Name:ZAPATA
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 1:859 WASHINGTON BLVD
Mailing Address - Street 2:SUITE #2
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84404-4962
Mailing Address - Country:US
Mailing Address - Phone:801-394-5240
Mailing Address - Fax:801-394-4779
Practice Address - Street 1:859 WASHINGTON BLVD
Practice Address - Street 2:SUITE #2
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84404-4962
Practice Address - Country:US
Practice Address - Phone:801-394-5240
Practice Address - Fax:801-394-4779
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5188190-99221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice