Provider Demographics
NPI:1609131473
Name:BULMANSKI, ZACHARY T (DDS)
Entity Type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:T
Last Name:BULMANSKI
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 1:1930 ALCOA HWY
Mailing Address - Street 2:A-335
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-1500
Mailing Address - Country:US
Mailing Address - Phone:865-305-9123
Mailing Address - Fax:865-305-4501
Practice Address - Street 1:1930 ALCOA HWY
Practice Address - Street 2:A-335
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1500
Practice Address - Country:US
Practice Address - Phone:865-305-9123
Practice Address - Fax:865-305-4501
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-09
Last Update Date:2012-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN311626179390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program