Provider Demographics
NPI:1982937843
Name:ZACHARY A. CARNOW, DDS, INC.
Entity Type:Organization
Organization Name:ZACHARY A. CARNOW, DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:CARNOW
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:323-723-8249
Mailing Address - Street 1:5453 E BEVERLY BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90022-2207
Mailing Address - Country:US
Mailing Address - Phone:323-723-8249
Mailing Address - Fax:323-721-9132
Practice Address - Street 1:5453 E BEVERLY BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90022-2207
Practice Address - Country:US
Practice Address - Phone:323-723-8249
Practice Address - Fax:323-721-9132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-10
Last Update Date:2009-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA586971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty