Provider Demographics
NPI:1710165519
Name:ZUCOSKY, JOHN T (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:T
Last Name:ZUCOSKY
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 1:195 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07660-1710
Mailing Address - Country:US
Mailing Address - Phone:201-641-1111
Mailing Address - Fax:
Practice Address - Street 1:195 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD PARK
Practice Address - State:NJ
Practice Address - Zip Code:07660-1710
Practice Address - Country:US
Practice Address - Phone:201-641-1111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-04
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNJ126041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice