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General NPI Number Information
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NPI Number | 1164637211
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Entity Type | Organization
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Legal Business Name | EDWARD R. ZANCA D.M.D., P.A.
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Dates
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Enumeration Date | 05/11/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5 CHILDRENS WAY
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City | ROCKPORT
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State | ME
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Zip | 04856-5746
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Country | US
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Telephone | 207-236-4356
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Fax | 207-236-0934
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Provider Business Mailing Address
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Address Line | PO BOX 1107
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City | ROCKPORT
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State | ME
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Zip | 04856-1107
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Country | US
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Telephone | 207-236-4356
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Fax | 207-236-0934
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Authorized Official
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Title or Position | OWNER
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Name | DR. EDWARD R. ZANCA
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Credential | D.M.D.
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Telephone | 207-236-4356
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 2713
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License Number State | ME
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