Healthcare Provider Details

I. General information

NPI: 1457801789
Provider Name (Legal Business Name): MILTON G. ZWEIG, DDS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2016
Last Update Date: 10/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 S REINO RD SUITE 100
NEWBURY PARK CA
91320-4284
US

IV. Provider business mailing address

400 S REINO RD SUITE 100
NEWBURY PARK CA
91320-4284
US

V. Phone/Fax

Practice location:
  • Phone: 805-498-0400
  • Fax:
Mailing address:
  • Phone: 805-498-0400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number45073
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number61864
License Number StateCA

VIII. Authorized Official

Name: KRISTINA UTECHT
Title or Position: OFFICE MANAGER
Credential:
Phone: 805-498-0400