Provider Demographics
NPI:1255567327
Name:VINCENT J ZUGAY DDS PA
Entity type:Organization
Organization Name:VINCENT J ZUGAY DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:ZUGAY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-839-5150
Mailing Address - Street 1:6130 OXON HILL RD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20745-3103
Mailing Address - Country:US
Mailing Address - Phone:301-839-5150
Mailing Address - Fax:301-839-2246
Practice Address - Street 1:6130 OXON HILL RD
Practice Address - Street 2:SUITE 302
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-3103
Practice Address - Country:US
Practice Address - Phone:301-839-5150
Practice Address - Fax:301-839-2246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-03
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMD40841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDMD4084OtherSTATE LICENCE INFORMATION