Provider Demographics
NPI:1982746475
Name:ZAHARAKOS, PETER C (DDS)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:C
Last Name:ZAHARAKOS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 WALNUT ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47025-1842
Mailing Address - Country:US
Mailing Address - Phone:812-537-1138
Mailing Address - Fax:812-537-2035
Practice Address - Street 1:5 E CENTER ST
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:IN
Practice Address - Zip Code:47025-1849
Practice Address - Country:US
Practice Address - Phone:812-537-1138
Practice Address - Fax:812-537-2035
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12006914A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice