Provider Demographics
NPI:1841582442
Name:ELIZABETH ZAUN, DDS, PC
Entity Type:Organization
Organization Name:ELIZABETH ZAUN, DDS, PC
Other - Org Name:ORCHARD FAMILY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MOUW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-484-1021
Mailing Address - Street 1:714 N FORDHAM AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60506-2715
Mailing Address - Country:US
Mailing Address - Phone:515-971-2207
Mailing Address - Fax:
Practice Address - Street 1:1480 N ORCHARD RD STE 104
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-7940
Practice Address - Country:US
Practice Address - Phone:630-708-7334
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-15
Last Update Date:2011-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0284421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty