Healthcare Provider Details

I. General information

NPI: 1770616260
Provider Name (Legal Business Name): HOWARD MARK ZOLOT DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 EXECUTIVE PARK 1538 TURNPIKE STREET
NORTH ANDOVER MA
01845-6225
US

IV. Provider business mailing address

114 EXECUTIVE PARK 1538 TURNPIKE STREET
NORTH ANDOVER MA
01845-6225
US

V. Phone/Fax

Practice location:
  • Phone: 978-687-7788
  • Fax: 978-687-2579
Mailing address:
  • Phone: 978-687-7788
  • Fax: 978-687-2579

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number15612
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: