Provider Demographics
NPI:1356566152
Name:ZATTERA, WALTER G (DDS PC)
Entity type:Individual
Prefix:
First Name:WALTER
Middle Name:G
Last Name:ZATTERA
Suffix:
Gender:M
Credentials:DDS PC
Other - Prefix:
Other - First Name:WALTER
Other - Middle Name:G
Other - Last Name:ZATTERA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS PC
Mailing Address - Street 1:120 W EASTMAN ST STE 203
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-5949
Mailing Address - Country:US
Mailing Address - Phone:847-394-5620
Mailing Address - Fax:
Practice Address - Street 1:120 W EASTMAN ST STE 203
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-5949
Practice Address - Country:US
Practice Address - Phone:847-394-5620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019192091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice