Provider Demographics
NPI:1447593330
Name:ZAMBRANO & ALVARADO DDS INC
Entity Type:Organization
Organization Name:ZAMBRANO & ALVARADO DDS INC
Other - Org Name:FRESH SMILE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:FREDDY
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAMBRANO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-660-8196
Mailing Address - Street 1:1666 MEDICAL CENTER DR STE 3
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92411-1257
Mailing Address - Country:US
Mailing Address - Phone:909-881-5007
Mailing Address - Fax:
Practice Address - Street 1:1666 MEDICAL CENTER DR STE 3
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92411-1257
Practice Address - Country:US
Practice Address - Phone:909-881-5007
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-29
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental