Provider Demographics
NPI:1558473199
Name:ZAVARELLA, MATTHEW MARTIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:MARTIN
Last Name:ZAVARELLA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3350 FOXCROFT DR
Mailing Address - Street 2:
Mailing Address - City:LEWIS CENTER
Mailing Address - State:OH
Mailing Address - Zip Code:43035-9270
Mailing Address - Country:US
Mailing Address - Phone:614-266-5370
Mailing Address - Fax:
Practice Address - Street 1:5101 FOREST DR
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:OH
Practice Address - Zip Code:43054-8215
Practice Address - Country:US
Practice Address - Phone:614-933-9800
Practice Address - Fax:614-933-9898
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0221411223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics