Healthcare Provider Details

I. General information

NPI: 1649264557
Provider Name (Legal Business Name): ROSS A ZIEGLER D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 09/07/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

278 HUNSBERGER LN
HARLEYSVILLE PA
19438-1812
US

IV. Provider business mailing address

278 HUNSBERGER LN
HARLEYSVILLE PA
19438-1812
US

V. Phone/Fax

Practice location:
  • Phone: 215-256-6850
  • Fax: 215-256-6850
Mailing address:
  • Phone: 215-256-6850
  • Fax: 215-256-6850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDS025463L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: