Healthcare Provider Details

I. General information

NPI: 1912986613
Provider Name (Legal Business Name): DAVID ALBIN ZIMLIKI DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2006
Last Update Date: 06/02/2020
Certification Date: 06/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2855 EASTERN BLVD
YORK PA
17402-2909
US

IV. Provider business mailing address

2855 EASTERN BLVD
YORK PA
17402-2909
US

V. Phone/Fax

Practice location:
  • Phone: 717-755-1007
  • Fax: 717-757-5625
Mailing address:
  • Phone: 717-434-8275
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDS035691
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: