Provider Demographics
NPI:1952423287
Name:ZALESKI, JOSHUA DAVID (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:DAVID
Last Name:ZALESKI
Suffix:
Gender:M
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:UNIVERSITY HEALTH CTR
Mailing Address - Street 2:55 CARLTON STREET
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30602-1526
Mailing Address - Country:US
Mailing Address - Phone:707-542-8700
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY HEALTH CTR
Practice Address - Street 2:55 CARLTON STREET
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30602-1526
Practice Address - Country:US
Practice Address - Phone:707-542-8700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2012-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADNO127791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice