Provider Demographics
NPI:1346438652
Name:GILBERTSON, ZACHARY D (DMD)
Entity Type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:D
Last Name:GILBERTSON
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 1:5533 E BELL RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-1228
Mailing Address - Country:US
Mailing Address - Phone:602-977-1110
Mailing Address - Fax:602-795-1420
Practice Address - Street 1:5533 E BELL RD
Practice Address - Street 2:SUITE 120
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-1228
Practice Address - Country:US
Practice Address - Phone:602-977-1110
Practice Address - Fax:602-795-1420
Is Sole Proprietor?:No
Enumeration Date:2007-10-11
Last Update Date:2009-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ64631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice