| Provider / Organization | NPI | Date Certified |
|---|---|---|
| JACQUELINE LEAH ZUBICK | 1225622442 | 2022-06-19 |
Jacqueline Leah Zubick is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1225622442. Registration indicates Jacqueline Leah Zubick is a provider of services with a specialization in Student, Health Care, Student in an Organized Health Care Education/Training Program (Student in an Organized Health Care Education/Training Program, ) (All Other Specialties & Provider Types, ) (Student in an Organized Health Care Education/Training Program, Student, Health Care) Access to Dentists-General (Dental Providers, Dentist) (Dental Providers, Dentist) (Dentist: General Practice, ) (Dental, ) (Dentist General Practice, Dental Providers) (Dentist, )
| Entity Type | Individual |
| Provider Name | Jacqueline Leah Zubick |
| Practice Office Address | 597 W 5300 S MURRAY, UT US |
| Practice Office Telephone | 8012663000 |
| Mailing Address | 597 W 5300 S MURRAY, UT 841235647 US |
| Business Telephone | 8012663000 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 530 S Wakara Way | Salt Lake City, UT 841081213 | 8015872162 |
| Code | Practice | License No State |
|---|---|---|
| 390200000X | Student, Health Care Student in an Organized Health Care Education/Training Program Student in an Organized Health Care Education/Training Program All Other Specialties & Provider Types Student in an Organized Health Care Education/Training Program Student, Health Care | |
| 1223G0001X PRIMARY | Access to Dentists-General Dental Providers Dentist Dental Providers Dentist Dentist: General Practice Dental Dentist General Practice Dental Providers Dentist | 12819692-9923
UT |