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General NPI Number Information
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NPI Number | 1730213000
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Entity Type | Individual
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Provider Name | JEFFREY NORMAN DZINGLE DDS, MS
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Gender | Male
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Dates
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Enumeration Date | 03/16/2007
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Last Update Date | 12/01/2011
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Provider Practice Location Address
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Address Line | 146 S INDUSTRIAL DR
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City | SALINE
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State | MI
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Zip | 48176-9493
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Country | US
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Telephone | 989-772-1334
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Fax | 989-773-0904
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Provider Business Mailing Address
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Address Line | 3120 PRIMROSE LN
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City | YPSILANTI
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State | MI
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Zip | 48197-3214
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Country | US
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Telephone | 734-717-2686
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Fax | 989-773-0904
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | MI2901019121
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 2901019121
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License Number State | MI
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