Provider Demographics
NPI:1912020314
Name:ZAVODNY, ROBERT ANDREW (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ANDREW
Last Name:ZAVODNY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2950 W MARKET ST
Mailing Address - Street 2:SUITE N-O
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-3614
Mailing Address - Country:US
Mailing Address - Phone:330-836-9511
Mailing Address - Fax:330-836-8417
Practice Address - Street 1:2950 W MARKET ST
Practice Address - Street 2:SUITE N-O
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-3614
Practice Address - Country:US
Practice Address - Phone:330-836-9511
Practice Address - Fax:330-836-8417
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-198541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice