Healthcare Provider Details

I. General information

NPI: 1972872844
Provider Name (Legal Business Name): AMY LYNN ZINN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMY LYNN BRENNAN

II. Dates (important events)

Enumeration Date: 12/22/2011
Last Update Date: 12/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17821 HIGHWAY 7 STE 2F
MINNETONKA MN
55345-4123
US

IV. Provider business mailing address

17821 HIGHWAY 7 STE 2F
MINNETONKA MN
55345-4123
US

V. Phone/Fax

Practice location:
  • Phone: 952-474-5622
  • Fax:
Mailing address:
  • Phone: 952-474-5622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number12997
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: