Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | DS039574 | PA |
NPI | 1003291055 |
---|---|
Provider Name | Brian Zebrick |
First Address | Lansdale, PA 19446-3803 |
Second Address | Lansdale, PA 19446-3803 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2015 |
Last Update Date | 01/03/2017 |