Provider Demographics
NPI:1346260296
Name:ZOUBEK, ZESTIVINAL (DDS)
Entity Type:Individual
Prefix:
First Name:ZESTIVINAL
Middle Name:
Last Name:ZOUBEK
Suffix:
Gender:F
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:PO BOX 39450
Mailing Address - Street 2:
Mailing Address - City:NINILCHIK
Mailing Address - State:AK
Mailing Address - Zip Code:99639-0450
Mailing Address - Country:US
Mailing Address - Phone:907-567-4444
Mailing Address - Fax:907-567-4446
Practice Address - Street 1:66334 ASPEN AV
Practice Address - Street 2:
Practice Address - City:NINILCHIK
Practice Address - State:AK
Practice Address - Zip Code:99639
Practice Address - Country:US
Practice Address - Phone:907-567-4444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK10951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice