Provider Demographics
NPI:1609926351
Name:ZARRELLA, JOHN WILLIAM (DMD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:WILLIAM
Last Name:ZARRELLA
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 1:171 MAIN STREET
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ASHLAND
Mailing Address - State:MA
Mailing Address - Zip Code:01721
Mailing Address - Country:US
Mailing Address - Phone:508-881-1280
Mailing Address - Fax:508-881-3529
Practice Address - Street 1:171 MAIN STREET
Practice Address - Street 2:SUITE 100
Practice Address - City:ASHLAND
Practice Address - State:MA
Practice Address - Zip Code:01721
Practice Address - Country:US
Practice Address - Phone:508-881-1280
Practice Address - Fax:508-881-3529
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA169141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice