MEDICARE: DR. MARTIN PAUL ZERENER D.M.D.

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
1	1223G0001X	General Practice Dentistry	8631	SC

General Provider Information

NPI Number	:	1952777195
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARTIN PAUL ZERENER D.M.D.

Provider Business Mailing Address
First Line	:	5422 FOREST DR
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29206-5412
Country	:	US
Telephone Number	:	803-753-8064
Fax Number	:

Provider Business Practice Location Address
First Line	:	5422 FOREST DR
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29206-5412
Country	:	US
Telephone Number	:	803-753-8064
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2015
Last Update Date	:	08/11/2015

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