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General NPI Number Information
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NPI Number | 1942458005
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Entity Type | Individual
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Provider Name | ALICE MALLOY ZEIGLER D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/03/2008
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Last Update Date | 10/08/2014
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Provider Practice Location Address
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Address Line | 704 N 17TH ST
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City | BOISE
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State | ID
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Zip | 83702-3905
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Country | US
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Telephone | 208-344-0134
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Fax |
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Provider Business Mailing Address
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Address Line | 1042 W PARKHILL DR
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City | BOISE
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State | ID
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Zip | 83702-1340
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Country | US
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Telephone | 404-402-0540
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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 | DN013523
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 4568
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License Number State | ID
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