Healthcare Provider Details

I. General information

NPI: 1033431598
Provider Name (Legal Business Name): MARGARET ZADNIK DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2010
Last Update Date: 02/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

439 MAIN ST
ISLIP NY
11751-3538
US

IV. Provider business mailing address

439 MAIN ST
ISLIP NY
11751-3538
US

V. Phone/Fax

Practice location:
  • Phone: 631-581-1150
  • Fax: 631-581-1152
Mailing address:
  • Phone: 631-581-1150
  • Fax: 631-581-1152

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number046114
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: