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Organization

TED D ZAHARAKO ESTATE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. ALICE JEAN PHILLIPS (PERSONAL RESPENTATIVE)
(812) 342-9986
Entity
Organization

Contact information

Practice address
3154 N NATIONAL RD, COLUMBUS, IN 47201-3170
(812) 372-0102
(812) 372-3875
Mailing address
431 WASHINGTON ST, COLUMBUS, IN 47201-6757
(812) 376-6676
(812) 379-2498

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12007403
IN

Other

Enumeration date
05/15/2013
Last updated
05/15/2013
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