Provider Demographics
NPI:1245324060
Name:ZUST, MARK ROBERT (DDS)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:ROBERT
Last Name:ZUST
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:36 4 SEASONS SHOPPING CTR
Mailing Address - Street 2:#300
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-3103
Mailing Address - Country:US
Mailing Address - Phone:636-928-1100
Mailing Address - Fax:636-928-1292
Practice Address - Street 1:80 GAILWOOD DR
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-6581
Practice Address - Country:US
Practice Address - Phone:636-928-1100
Practice Address - Fax:636-928-1292
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2010-04-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO121231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice