Healthcare Provider Details

I. General information

NPI: 1578568861
Provider Name (Legal Business Name): RICHARD C ZIEGLER D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/15/2005
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4447 TALMADGE RD STE A
TOLEDO OH
43623-3517
US

IV. Provider business mailing address

4447 TALMADGE RD STE A
TOLEDO OH
43623-3517
US

V. Phone/Fax

Practice location:
  • Phone: 419-479-3939
  • Fax: 419-479-3933
Mailing address:
  • Phone: 419-479-3939
  • Fax: 419-479-3933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number17266
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: