Provider Demographics
NPI:1760591655
Name:ZOMBEK, DEBRA S (DDS PA)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:S
Last Name:ZOMBEK
Suffix:
Gender:F
Credentials:DDS PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:964 NC HWY 42 WEST
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27520
Mailing Address - Country:US
Mailing Address - Phone:919-553-7695
Mailing Address - Fax:919-553-9054
Practice Address - Street 1:964 NC HWY 42 WEST
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520
Practice Address - Country:US
Practice Address - Phone:919-553-7695
Practice Address - Fax:919-553-9054
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC78541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice