Provider Demographics
NPI:1477579886
Name:ZVOLANEK, JAY WILLIAM (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:WILLIAM
Last Name:ZVOLANEK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:JAY
Other - Middle Name:WILLIAM
Other - Last Name:ZVOLANEK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:3080 OGDEN AVE
Mailing Address - Street 2:SUITE 305
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-1691
Mailing Address - Country:US
Mailing Address - Phone:630-420-1505
Mailing Address - Fax:630-420-7502
Practice Address - Street 1:3080 OGDEN AVE
Practice Address - Street 2:SUITE 305
Practice Address - City:LISLE
Practice Address - State:IL
Practice Address - Zip Code:60532-1691
Practice Address - Country:US
Practice Address - Phone:630-420-1505
Practice Address - Fax:630-420-7502
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL19-159201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice