Healthcare Provider Details

I. General information

NPI: 1518577329
Provider Name (Legal Business Name): FRANK HENRY ZIMMERMAN DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2020
Last Update Date: 08/06/2020
Certification Date: 08/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3676 CROWN POINT CT
JACKSONVILLE FL
32257-5966
US

IV. Provider business mailing address

12868 BAY PLANTATION DR
JACKSONVILLE FL
32223-0784
US

V. Phone/Fax

Practice location:
  • Phone: 904-268-2011
  • Fax:
Mailing address:
  • Phone: 904-200-0319
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN25352
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: