Provider Demographics
NPI:1013271212
Name:ZORN, CANDACE (DDS)
Entity Type:Individual
Prefix:DR
First Name:CANDACE
Middle Name:
Last Name:ZORN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 CAMBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:GLEN MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19342-1545
Mailing Address - Country:US
Mailing Address - Phone:410-812-8006
Mailing Address - Fax:
Practice Address - Street 1:17121 YORK RD
Practice Address - Street 2:
Practice Address - City:PARKTON
Practice Address - State:MD
Practice Address - Zip Code:21120-9718
Practice Address - Country:US
Practice Address - Phone:410-329-6866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0411761223G0001X
MD154521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice