Organization
ZACKO & SHATLUCH LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GEORGE BERNARD ZACKO DDS (OWNER DENTIST)
(703) 471-6600
Entity
Organization
Contact information
Practice address
1712 CLUBHOUSE ROAD, SUITE 106, RESTON, VA 20190
(703) 471-6600
(703) 471-1675
Mailing address
1712 CLUBHOUSE ROAD, SUITE 106, RESTON, VA 20190
(703) 471-6600
(703) 471-1675
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/12/2006
Last updated
08/22/2020
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