Provider Demographics
NPI:1245541507
Name:ZAWADZKY, JAVIER MAURICIO (DMD)
Entity type:Individual
Prefix:
First Name:JAVIER
Middle Name:MAURICIO
Last Name:ZAWADZKY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10620 NW 10TH ST
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33322-7810
Mailing Address - Country:US
Mailing Address - Phone:954-600-6839
Mailing Address - Fax:
Practice Address - Street 1:10620 NW 10TH ST
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33322-7810
Practice Address - Country:US
Practice Address - Phone:954-600-6839
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-01
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN19098122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist