Provider Demographics
NPI:1407649015
Name:BRINK, ZANZAN (DMD)
Entity type:Individual
Prefix:
First Name:ZANZAN
Middle Name:
Last Name:BRINK
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 RESERVOIR AVE
Mailing Address - Street 2:
Mailing Address - City:CHESTNUT HILL
Mailing Address - State:MA
Mailing Address - Zip Code:02467-1343
Mailing Address - Country:US
Mailing Address - Phone:508-948-9914
Mailing Address - Fax:
Practice Address - Street 1:48 RESERVOIR AVE
Practice Address - Street 2:
Practice Address - City:CHESTNUT HILL
Practice Address - State:MA
Practice Address - Zip Code:02467-1343
Practice Address - Country:US
Practice Address - Phone:508-948-9914
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-27
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADNNE10862122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist