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General NPI Number Information
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NPI Number | 1437905213
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Entity Type | Individual
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Provider Name | SARAH ROSE ZENNER D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/24/2024
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 1801 W WISCONSIN AVE
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City | MILWAUKEE
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State | WI
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Zip | 53233-2186
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Country | US
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Telephone | 414-288-6790
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Fax |
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Provider Business Mailing Address
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Address Line | 54380 JACK DR
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City | MACOMB
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State | MI
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Zip | 48042-2245
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Country | US
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Telephone | 586-337-7013
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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 | 6001514-15
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License Number State | WI
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