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General NPI Number Information
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NPI Number | 1568528404
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Entity Type | Individual
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Provider Name | THOMAS J ZBARACKI JR. DDS MS
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Gender | Male
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Dates
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Enumeration Date | 12/28/2006
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Last Update Date | 11/30/2010
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Provider Practice Location Address
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Address Line | 5005 MATTERHORN DRIVE STE 1
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City | DULUTH
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State | MN
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Zip | 55811
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Country | US
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Telephone | 218-625-8630
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Fax | 218-625-8632
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Provider Business Mailing Address
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Address Line | 5005 MATTERHORN DRIVE STE 1
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City | DULUTH
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State | MN
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Zip | 55811
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Country | US
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Telephone | 218-625-8630
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Fax | 218-625-8632
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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 | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | D8329
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License Number State | MN
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