Provider Demographics
NPI:1003622648
Name:ALEXANDER M ZUK DMD LLC
Entity type:Organization
Organization Name:ALEXANDER M ZUK DMD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:ZUK
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:503-798-5148
Mailing Address - Street 1:1040 LURADEL AVE S
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-6029
Mailing Address - Country:US
Mailing Address - Phone:503-798-5148
Mailing Address - Fax:
Practice Address - Street 1:1805 E NOB HILL ST SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-5237
Practice Address - Country:US
Practice Address - Phone:503-364-9515
Practice Address - Fax:503-365-9713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental