Healthcare Provider Details

I. General information

NPI: 1881139145
Provider Name (Legal Business Name): ZOMBEK ORTHODONTICS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2016
Last Update Date: 12/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1040 WESTON RD STE 200
WESTON FL
33326-1977
US

IV. Provider business mailing address

1040 WESTON RD STE 200
WESTON FL
33326-1977
US

V. Phone/Fax

Practice location:
  • Phone: 954-389-7906
  • Fax:
Mailing address:
  • Phone: 954-389-7906
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. STEVEN ZOMBEK
Title or Position: PRESIDENT
Credential: DMD
Phone: 954-389-7906