Healthcare Provider Details

I. General information

NPI: 1487824959
Provider Name (Legal Business Name): ZAVARO & EZZI P.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2008
Last Update Date: 06/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 WASHINGTON ST # 341
BOSTON MA
02108-5177
US

IV. Provider business mailing address

333 WASHINGTON ST # 341
BOSTON MA
02108-5177
US

V. Phone/Fax

Practice location:
  • Phone: 617-523-5151
  • Fax:
Mailing address:
  • Phone: 617-523-5151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number17865
License Number StateMA

VIII. Authorized Official

Name: DR. ELIAS ZAVARO
Title or Position: DENTIST
Credential: D M D
Phone: 617-523-5151