Provider Demographics
NPI:1043363450
Name:WILLIAM H. ZOVICKIAN, DDS
Entity type:Organization
Organization Name:WILLIAM H. ZOVICKIAN, DDS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:H
Authorized Official - Last Name:ZOVICKIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:860-364-0204
Mailing Address - Street 1:57 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:CT
Mailing Address - Zip Code:06069-2018
Mailing Address - Country:US
Mailing Address - Phone:860-364-0204
Mailing Address - Fax:860-364-0505
Practice Address - Street 1:57 MAIN ST
Practice Address - Street 2:
Practice Address - City:SHARON
Practice Address - State:CT
Practice Address - Zip Code:06069-2018
Practice Address - Country:US
Practice Address - Phone:860-364-0204
Practice Address - Fax:860-364-0505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty