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Organization

I ZAK DDS PROF DENTAL CORP

Active
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Organization

I ZAK DDS PROF DENTAL CORP

Active
Other names
Dr. Zak Long Beach Dental Care
Organization subpart
No

Provider details

NPI number
Authorized official
ILYA ZAK (PRESIDENT/CEO)
(310) 805-5201
Entity
Organization

Contact information

Practice address
3620 LONG BEACH BLVD STE B6, LONG BEACH, CA 90807-6008
(562) 426-6458
Mailing address
10501 LAKEWOOD BLVD, DOWNEY, CA 90241-2709

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1223E0200X
Endodontics
1223G0001X
General Practice Dentistry
1223P0300X
Periodontics
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry

Other

Enumeration date
03/30/2022
Last updated
03/30/2022
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