Basic Information
| Provider Information | |||||||||
| NPI: | 1003291055 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ZEBRICK | ||||||||
| FirstName: | BRIAN | ||||||||
| MiddleName: | |||||||||
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| Credential: | DDS, MS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 456 E HANCOCK ST | ||||||||
| Address2: | |||||||||
| City: | LANSDALE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 194463803 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2157600061 | ||||||||
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| Practice Location | |||||||||
| Address1: | 456 E HANCOCK ST | ||||||||
| Address2: | |||||||||
| City: | LANSDALE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 194463803 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2157600061 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/20/2015 | ||||||||
| LastUpdateDate: | 03/01/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223X0400X | DS039574 | PA | Y | Dental Providers | Dentist | Orthodontics and Dentofacial Orthopedics |
No ID Information.