Healthcare Provider Details

I. General information

NPI: 1659458990
Provider Name (Legal Business Name): SZILARD ZOMBOR DD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2027 196TH ST SW R1
LYNNWOOD WA
98036-7073
US

IV. Provider business mailing address

2027 196TH ST SW R1
LYNNWOOD WA
98036-7073
US

V. Phone/Fax

Practice location:
  • Phone: 425-697-3907
  • Fax:
Mailing address:
  • Phone: 425-697-3907
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122400000X
TaxonomyDenturist
License NumberDN00000224
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: