Provider Demographics
NPI:1730392689
Name:ZABOROVSKY, ANNA
Entity type:Individual
Prefix:DR
First Name:ANNA
Middle Name:
Last Name:ZABOROVSKY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:648 WASHINGTON ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062
Mailing Address - Country:US
Mailing Address - Phone:781-551-0235
Mailing Address - Fax:781-551-0428
Practice Address - Street 1:648 WASHINGTON ST
Practice Address - Street 2:SUITE 204
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062
Practice Address - Country:US
Practice Address - Phone:781-551-0235
Practice Address - Fax:781-551-0428
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA184261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0277495Medicaid