MEDICARE: DR. MICHAEL H ZIEGLER D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	5977	WA

General Provider Information

NPI Number	:	1073724472
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL H ZIEGLER D.D.S.

Provider Business Mailing Address
First Line	:	870 11TH AVE
Second Line	:
City	:	LONGVIEW
State	:	WA
Zip	:	98632-2402
Country	:	US
Telephone Number	:	360-425-4900
Fax Number	:	360-636-4641

Provider Business Practice Location Address
First Line	:	870 11TH AVE
Second Line	:
City	:	LONGVIEW
State	:	WA
Zip	:	98632-2402
Country	:	US
Telephone Number	:	360-425-4900
Fax Number	:	360-636-4641

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/25/2007
Last Update Date	:	07/08/2007

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