Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223D0001X | Dental Public Health | 50 - 055978 | NY |
N | 1223D0001X | Dental Public Health | DN1855922 | MA |
Y | 1223P0221X | Pediatric Dentist | 50 - 055978 | NY |
N | 1223P0221X | Pediatric Dentist | DN1855922 | MA |
NPI | 1417152810 |
---|---|
Provider Name | Dr. Athanasios I. Zavras |
First Address | Dover, MA 02030-2426 |
Second Address | New York, NY 10032-3720 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2007 |
Last Update Date | 27/02/2013 |