Provider Demographics
NPI:1679042360
Name:ZAUL & SMITH PEDIATRIC DENTISTRY
Entity Type:Organization
Organization Name:ZAUL & SMITH PEDIATRIC DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:CICELY
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:650-906-5468
Mailing Address - Street 1:120 S EL CAMINO REAL APT 308
Mailing Address - Street 2:
Mailing Address - City:MILLBRAE
Mailing Address - State:CA
Mailing Address - Zip Code:94030-3136
Mailing Address - Country:US
Mailing Address - Phone:650-906-5468
Mailing Address - Fax:
Practice Address - Street 1:1720 EL CAMINO REAL STE 101
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-3211
Practice Address - Country:US
Practice Address - Phone:650-906-5468
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-26
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty