Provider Demographics
NPI:1548332919
Name:ZAZZARO, JOHN J (DMD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:J
Last Name:ZAZZARO
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 1:316 MAIN ST S
Mailing Address - Street 2:
Mailing Address - City:SOUTHBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06488-4238
Mailing Address - Country:US
Mailing Address - Phone:203-246-0244
Mailing Address - Fax:203-264-5299
Practice Address - Street 1:316 MAIN ST S
Practice Address - Street 2:
Practice Address - City:SOUTHBURY
Practice Address - State:CT
Practice Address - Zip Code:06488-4238
Practice Address - Country:US
Practice Address - Phone:203-246-0244
Practice Address - Fax:203-264-5299
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT65291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice