Healthcare Provider Details

I. General information

NPI: 1336364496
Provider Name (Legal Business Name): DAVID JOHNATHON ZYBER DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

381 N SAGINAW
LAPEER MI
48446
US

IV. Provider business mailing address

57 STOCK RD
METAMORA MI
48455
US

V. Phone/Fax

Practice location:
  • Phone: 810-664-4542
  • Fax: 810-664-3580
Mailing address:
  • Phone: 810-678-3745
  • Fax: 810-664-3580

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number1809172
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: