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General NPI Number Information
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NPI Number | 1073207536
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Entity Type | Organization
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Legal Business Name | MICHAEL A ZIMMERMAN, DMD, PA
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Dates
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Enumeration Date | 06/07/2023
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Last Update Date | 06/07/2023
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Provider Practice Location Address
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Address Line | 127 SOUTHPORT ROAD
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City | SPARTANBURG
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State | SC
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Zip | 29306-3815
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Country | US
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Telephone | 864-595-1203
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Fax | 864-336-2992
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Provider Business Mailing Address
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Address Line | 127 SOUTHPORT ROAD
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City | SPARTANBURG
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State | SC
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Zip | 29306-3815
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Country | US
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Telephone | 864-595-1203
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Fax | 864-336-2992
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | MICHAEL ALLEN ZIMMERMAN
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Credential | DMD
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Telephone | 864-595-1203
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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