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General NPI Number Information
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NPI Number | 1063186377
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Entity Type | Individual
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Provider Name | FADI ZRIK DDS
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Gender | Male
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Dates
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Enumeration Date | 08/02/2021
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Last Update Date | 08/02/2021
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Provider Practice Location Address
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Address Line | 7859 6TH ST
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City | WELLINGTON
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State | CO
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Zip | 80549-5045
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Country | US
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Telephone | 970-568-4442
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Fax |
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Provider Business Mailing Address
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Address Line | 6535 INDEPENDENCE ST
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City | FREDERICK
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State | CO
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Zip | 80516-9764
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Country | US
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Telephone | 703-341-9160
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 00204851
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License Number State | CO
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