Provider Demographics
NPI:1952581456
Name:ZAMBON, DANIELA A (DDS MS)
Entity Type:Individual
Prefix:DR
First Name:DANIELA
Middle Name:A
Last Name:ZAMBON
Suffix:
Gender:F
Credentials:DDS MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1757 BROAD PARK CIRCLE NORTH
Mailing Address - Street 2:SUITE 301
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063
Mailing Address - Country:US
Mailing Address - Phone:817-453-7766
Mailing Address - Fax:817-887-5625
Practice Address - Street 1:1757 BROAD PARK CIRCLE NORTH
Practice Address - Street 2:SUITE 301
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063
Practice Address - Country:US
Practice Address - Phone:817-453-7766
Practice Address - Fax:817-887-5625
Is Sole Proprietor?:No
Enumeration Date:2007-11-13
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX234381223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics