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General NPI Number Information
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NPI Number | 1083424311
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Entity Type | Organization
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Legal Business Name | ZIMMERMAN FAMILY DENTISTRY, INC.
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Dates
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Enumeration Date | 01/09/2025
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 114 W PENN ST
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City | MARTINSBURG
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State | PA
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Zip | 16662-1113
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Country | US
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Telephone | 814-793-4362
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Fax | 814-793-4362
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Provider Business Mailing Address
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Address Line | 114 W PENN ST
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City | MARTINSBURG
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State | PA
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Zip | 16662-1113
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Country | US
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Telephone | 814-793-4362
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Fax | 814-793-4362
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. JONATHAN LUKE ZIMMERMAN
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Credential | DDS
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Telephone | 814-494-1135
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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