Basic Information
| Provider Information | |||||||||
| NPI: | 1801002050 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ZVONKINA | ||||||||
| FirstName: | ALLA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.D.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10 INCA LN APT 1 | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941154253 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4154404233 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1333 BUSH ST. | ||||||||
| Address2: | ON LOK SENIOR HEALTH | ||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 94109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4152928888 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/15/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223G0001X | 46157 | CA | Y | Dental Providers | Dentist | General Practice |
No ID Information.