Provider Demographics
NPI:1598898868
Name:DEEGAN, EFFIE ZANTOPOULOS (DMD)
Entity Type:Individual
Prefix:DR
First Name:EFFIE
Middle Name:ZANTOPOULOS
Last Name:DEEGAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 OLD SHORT HILLS RD
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-1020
Mailing Address - Country:US
Mailing Address - Phone:973-736-4432
Mailing Address - Fax:
Practice Address - Street 1:23 OLD SHORT HILLS RD
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-1020
Practice Address - Country:US
Practice Address - Phone:973-736-4432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ165241223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics