Healthcare Provider Details

I. General information

NPI: 1174533731
Provider Name (Legal Business Name): ORESTE D ZANNI DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126A PLEASANT VALLEY STREET
METHURN MA
01844
US

IV. Provider business mailing address

126A PLEASANT VALLEY STREET
METHUEN MA
01844
US

V. Phone/Fax

Practice location:
  • Phone: 978-688-5646
  • Fax: 978-688-5647
Mailing address:
  • Phone: 978-688-5646
  • Fax: 978-688-5647

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number12374
License Number StateMA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: