Provider Demographics
NPI:1508976408
Name:ZAZZARO, LOUIS PAUL (DMD)
Entity Type:Individual
Prefix:
First Name:LOUIS
Middle Name:PAUL
Last Name:ZAZZARO
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 1:100 PAVONIA AVE
Mailing Address - Street 2:SUITE 408
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07310-2778
Mailing Address - Country:US
Mailing Address - Phone:201-626-6210
Mailing Address - Fax:201-626-6211
Practice Address - Street 1:100 PAVONIA AVE
Practice Address - Street 2:SUITE 408
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07310-2778
Practice Address - Country:US
Practice Address - Phone:201-626-6210
Practice Address - Fax:201-626-6211
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02075000122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist