Provider Demographics
NPI:1174677215
Name:ZEFFERY, DAVID T (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:T
Last Name:ZEFFERY
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 1:444 PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:MUNDELEIN
Mailing Address - State:IL
Mailing Address - Zip Code:60060-1963
Mailing Address - Country:US
Mailing Address - Phone:847-566-5100
Mailing Address - Fax:847-566-5160
Practice Address - Street 1:444 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:MUNDELEIN
Practice Address - State:IL
Practice Address - Zip Code:60060-1963
Practice Address - Country:US
Practice Address - Phone:847-566-5100
Practice Address - Fax:847-566-5160
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice