Provider Demographics
NPI:1902097579
Name:DABBAS, ZAIN ODEH (DDS)
Entity Type:Individual
Prefix:
First Name:ZAIN
Middle Name:ODEH
Last Name:DABBAS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1102 ALBEMARLE WAY
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30017
Mailing Address - Country:US
Mailing Address - Phone:678-779-5851
Mailing Address - Fax:
Practice Address - Street 1:2594 LOGANVIILE HWY, # 102
Practice Address - Street 2:
Practice Address - City:GRAYSON
Practice Address - State:GA
Practice Address - Zip Code:30017
Practice Address - Country:US
Practice Address - Phone:678-672-1590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-07
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN013618122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist