Provider Demographics
NPI:1477808616
Name:DR DANIEL ZEDEKER
Entity Type:Organization
Organization Name:DR DANIEL ZEDEKER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:QWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ZEDEKER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:914-693-6656
Mailing Address - Street 1:18 ASHFORD AVE
Mailing Address - Street 2:SUITE MM
Mailing Address - City:DOBBS FERRY
Mailing Address - State:NY
Mailing Address - Zip Code:10522-1823
Mailing Address - Country:US
Mailing Address - Phone:914-693-6656
Mailing Address - Fax:
Practice Address - Street 1:18 ASHFORD AVE
Practice Address - Street 2:SUITE MM
Practice Address - City:DOBBS FERRY
Practice Address - State:NY
Practice Address - Zip Code:10522-1823
Practice Address - Country:US
Practice Address - Phone:914-693-6656
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DR. DANIEL ZEDEKER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-07-13
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1-37965261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental