Individual
ZENA MOURABET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
8 MEDICAL DRIVE, PART JEFFERSON STATION, NY 11776
(631) 928-8585
(631) 509-0334
Mailing address
8 MEDICAL DRIVE, PART JEFFERSON STATION, NY 11776
(631) 928-8585
(631) 509-0334
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
063248
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07733599
—
NY
Enumeration date
06/23/2021
Last updated
02/09/2024
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