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General NPI Number Information
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NPI Number | 1508274499
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Entity Type | Individual
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Provider Name | CASSANDRA MAE ZELENAK D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 07/24/2014
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Last Update Date | 07/24/2014
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Provider Practice Location Address
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Address Line | 215 LOGAN ST SUITE 41
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City | WILLIAMSON
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State | WV
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Zip | 25661
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Country | US
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Telephone | 304-236-2366
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Fax | 304-899-2227
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Provider Business Mailing Address
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Address Line | 404 PRICKETTS FORT ROAD
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City | FAIRMONT
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State | WV
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Zip | 26554
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Country | US
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Telephone | 304-376-5728
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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 | 4119
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License Number State | WV
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