Provider Demographics
NPI:1326159849
Name:ZGRODNIK, JOSEPH F (DMD PC)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:F
Last Name:ZGRODNIK
Suffix:
Gender:M
Credentials:DMD PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:264 ELM STREET
Mailing Address - Street 2:SUITE 5
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-2857
Mailing Address - Country:US
Mailing Address - Phone:413-586-0555
Mailing Address - Fax:413-584-0684
Practice Address - Street 1:264 ELM STREET
Practice Address - Street 2:SUITE 5
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-2857
Practice Address - Country:US
Practice Address - Phone:413-586-0555
Practice Address - Fax:413-584-0684
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA100131223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics