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Organization
I ZAK DDS PROF DENTAL CORP
Active
Organization
I ZAK DDS PROF DENTAL CORP
Active
Other names
Dr. Zak Family Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
ILYA ZAK DDS (PRESIDENT/CEO)
(310) 805-5201
Entity
Organization
Contact information
Practice address
3355 COCHRAN ST STE 206, SIMI VALLEY, CA 93063-2532
(805) 520-1100
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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