Provider Demographics
NPI:1538291133
Name:ZALESKI, CHESTER A (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHESTER
Middle Name:A
Last Name:ZALESKI
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 1:62 W COLUMBUS AVE
Mailing Address - Street 2:
Mailing Address - City:CORRY
Mailing Address - State:PA
Mailing Address - Zip Code:16407-1136
Mailing Address - Country:US
Mailing Address - Phone:814-665-3621
Mailing Address - Fax:814-664-4117
Practice Address - Street 1:62 W COLUMBUS AVE
Practice Address - Street 2:
Practice Address - City:CORRY
Practice Address - State:PA
Practice Address - Zip Code:16407-1136
Practice Address - Country:US
Practice Address - Phone:814-665-3621
Practice Address - Fax:814-664-4117
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS022884L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist