Provider Demographics
NPI:1396846655
Name:ZABLOTSKY, NEVIN (DMD)
Entity Type:Individual
Prefix:DR
First Name:NEVIN
Middle Name:
Last Name:ZABLOTSKY
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 1:37 TIMBER LANE
Mailing Address - Street 2:
Mailing Address - City:SO BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05403
Mailing Address - Country:US
Mailing Address - Phone:802-862-1435
Mailing Address - Fax:802-864-6998
Practice Address - Street 1:37 TIMBER LANE
Practice Address - Street 2:
Practice Address - City:SO BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05403
Practice Address - Country:US
Practice Address - Phone:802-862-1435
Practice Address - Fax:802-864-6998
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT01600007441223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT100S221Medicaid