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General NPI Number Information
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NPI Number | 1609262443
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Entity Type | Organization
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Legal Business Name | JENNIFER L ZOLL, DDS, LLC
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Dates
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Enumeration Date | 04/08/2015
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Last Update Date | 04/08/2015
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Provider Practice Location Address
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Address Line | 3036 W SYLVANIA AVE
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City | TOLEDO
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State | OH
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Zip | 43613-4128
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Country | US
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Telephone | 419-474-0733
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Fax | 419-474-5407
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Provider Business Mailing Address
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Address Line | 3036 W SYLVANIA AVE
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City | TOLEDO
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State | OH
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Zip | 43613-4128
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Country | US
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Telephone | 419-474-0733
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Fax | 419-474-5407
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Authorized Official
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Title or Position | OWNER
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Name | DR. JENNIFER LYNN ZOLL
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Credential | DDS
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Telephone | 419-474-0733
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 022954
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 18423
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License Number State | OH
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