Provider Demographics
NPI:1780737668
Name:ZARGAR, FRED (DDS)
Entity type:Individual
Prefix:DR
First Name:FRED
Middle Name:
Last Name:ZARGAR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18404 N. TATUM BLVD.
Mailing Address - Street 2:STE.203
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032
Mailing Address - Country:US
Mailing Address - Phone:602-482-3100
Mailing Address - Fax:602-923-3463
Practice Address - Street 1:18404 N. TATUM BLVD
Practice Address - Street 2:STE 203
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032
Practice Address - Country:US
Practice Address - Phone:602-482-3100
Practice Address - Fax:602-923-3463
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD45741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice