Provider Demographics
NPI:1972720019
Name:ZATOPEK, DAVID LELAND (DDS)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:LELAND
Last Name:ZATOPEK
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 1:259 E COLORADO ST
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE
Mailing Address - State:TX
Mailing Address - Zip Code:78945-2243
Mailing Address - Country:US
Mailing Address - Phone:979-968-8889
Mailing Address - Fax:
Practice Address - Street 1:259 E COLORADO ST
Practice Address - Street 2:
Practice Address - City:LA GRANGE
Practice Address - State:TX
Practice Address - Zip Code:78945-2243
Practice Address - Country:US
Practice Address - Phone:979-968-8889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD123971223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry