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Organization
I ZAK DDS PROF DENTAL CORP
Active
Organization
I ZAK DDS PROF DENTAL CORP
Active
Other names
Golden State Smiles, Dr. Zak San Leandro Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
ILYA ZAK DDS (CEO/PRESIDENT)
(310) 503-9277
Entity
Organization
Contact information
Practice address
15301 WASHINGTON AVE, SAN LEANDRO, CA 94579-1811
(510) 351-6820
Mailing address
10501 LAKEWOOD BLVD, DOWNEY, CA 90241-2709
(310) 503-9277
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
—
—
1223P0106X
Oral and Maxillofacial Pathology Dentistry
—
—
1223P0221X
Pediatric Dentistry
—
—
1223P0300X
Periodontics
—
—
1223P0700X
Prosthodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
07/25/2019
Last updated
07/25/2019
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