Provider Demographics
NPI:1669627865
Name:VARBLE, ZACHARY (DMD)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:
Last Name:VARBLE
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 1:2050 BLUESTONE DR
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63303-5977
Mailing Address - Country:US
Mailing Address - Phone:618-531-8702
Mailing Address - Fax:
Practice Address - Street 1:2050 BLUESTONE DR
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63303-5977
Practice Address - Country:US
Practice Address - Phone:618-531-8702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-02
Last Update Date:2011-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190271451223X0400X
IN12011272A1223X0400X
MO20090057771223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics