Provider Demographics
NPI:1851007462
Name:ZEAL DENTAL P.C.
Entity Type:Organization
Organization Name:ZEAL DENTAL P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:AMER
Authorized Official - Middle Name:
Authorized Official - Last Name:MALIK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-624-3188
Mailing Address - Street 1:446 ROUTE 304 STE A
Mailing Address - Street 2:
Mailing Address - City:BARDONIA
Mailing Address - State:NY
Mailing Address - Zip Code:10954-1646
Mailing Address - Country:US
Mailing Address - Phone:845-624-3188
Mailing Address - Fax:
Practice Address - Street 1:446 ROUTE 304 STE A
Practice Address - Street 2:
Practice Address - City:BARDONIA
Practice Address - State:NY
Practice Address - Zip Code:10954-1646
Practice Address - Country:US
Practice Address - Phone:845-624-3188
Practice Address - Fax:845-215-5850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-26
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty