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General NPI Number Information
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NPI Number | 1508082272
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Entity Type | Individual
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Provider Name | RICHARD EDWARD ZOLLINGER D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 01/14/2008
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Provider Practice Location Address
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Address Line | 230 E WHITLEY ST # 265
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City | CHURUBUSCO
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State | IN
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Zip | 46723-1506
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Country | US
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Telephone | 260-693-2177
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Fax | 260-693-6422
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Provider Business Mailing Address
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Address Line | 3770 S MERIDIAN RD
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City | COLUMBIA CITY
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State | IN
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Zip | 46725-9781
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Country | US
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Telephone | 260-248-2851
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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 | 12008759
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License Number State | IN
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