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General NPI Number Information
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NPI Number | 1285143990
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Entity Type | Individual
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Provider Name | ZACHARY DAVID SIEFRING DMD
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Gender | Male
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Dates
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Enumeration Date | 09/26/2017
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Last Update Date | 03/24/2019
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Provider Practice Location Address
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Address Line | 440 BUR OAK DR
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City | GREENVILLE
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State | OH
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Zip | 45331-4307
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Country | US
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Telephone | 937-548-5496
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Fax |
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Provider Business Mailing Address
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Address Line | 440 BUR OAK DR
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City | GREENVILLE
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State | OH
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Zip | 45331-4307
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Country | US
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Telephone | 419-953-2548
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 30.025170
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License Number State | OH
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