Provider Demographics
NPI:1639939176
Name:ZAKHARY, NORA
Entity Type:Individual
Prefix:
First Name:NORA
Middle Name:
Last Name:ZAKHARY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 BRIGHTON WAY
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:MO
Mailing Address - Zip Code:63105-3601
Mailing Address - Country:US
Mailing Address - Phone:440-339-5713
Mailing Address - Fax:
Practice Address - Street 1:115 BRIGHTON WAY
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:MO
Practice Address - Zip Code:63105-3601
Practice Address - Country:US
Practice Address - Phone:440-339-5713
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-21
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1223G0001X1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice