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NPI Code Detail

MEDICARE: JENNIFER L ZOLL, DDS, LLC

MEDICARE: JENNIFER L ZOLL, DDS, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223P0221XPediatric Dentistry022954OH
21223P0221XPediatric Dentistry18423OH

Other Identifiers

General Provider Information

NPI Number : 1609262443
Entity Type Code : Organization
Provider Name (Legal Business Name) : JENNIFER L ZOLL, DDS, LLC
Provider Business Mailing Address
First Line : 3036 W SYLVANIA AVE
Second Line :
City : TOLEDO
State : OH
Zip : 43613-4128
Country : US
Telephone Number : 419-474-0733
Fax Number : 419-474-5407
Provider Business Practice Location Address
First Line : 3036 W SYLVANIA AVE
Second Line :
City : TOLEDO
State : OH
Zip : 43613-4128
Country : US
Telephone Number : 419-474-0733
Fax Number : 419-474-5407
Authorized Official
Title or Position : OWNER
Name : DR. JENNIFER LYNN ZOLL
Credential : DDS
Telephone Number : 419-474-0733
Provider Enumeration Date : 04/08/2015
Last Update Date : 04/08/2015

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Directions to “JENNIFER L ZOLL, DDS, LLC ” Practice Location

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