Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223P0221X | Pediatric Dentist | 21069 | TX |
Y | 1223P0221X | Pediatric Dentist | 21571 | MA |
NPI | 1033274907 |
---|---|
Provider Name | Dr. Derek Stephen Zurn |
First Address | Sudbury, MA 01776-2236 |
Second Address | Stoughton, MA 02072-3650 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2006 |
Last Update Date | 14/11/2007 |