Provider Demographics
NPI:1225115660
Name:ZINK, PHILIP H (DMD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:H
Last Name:ZINK
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 S PROCTOR KNOTT AVE
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:KY
Mailing Address - Zip Code:40033-1219
Mailing Address - Country:US
Mailing Address - Phone:270-692-4339
Mailing Address - Fax:270-692-5697
Practice Address - Street 1:219 S PROCTOR KNOTT AVE
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:KY
Practice Address - Zip Code:40033-1219
Practice Address - Country:US
Practice Address - Phone:270-692-4339
Practice Address - Fax:270-692-5697
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY46141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice