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NPI Code Detail

MEDICARE: JAMES P ZIUCHKOVSKI DDS, MS

MEDICARE:   JAMES P ZIUCHKOVSKI  DDS, MS
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
11223X0400XOrthodontics and Dentofacial Orthopedics Dentistry8908CO

General Provider Information

NPI Number : 1134145303
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES P ZIUCHKOVSKI DDS, MS
Provider Business Mailing Address
First Line : 6010 ERIN PARK DR
Second Line : SUITE 2
City : COLORADO SPRINGS
State : CO
Zip : 80918-3404
Country : US
Telephone Number : 719-593-7942
Fax Number : 719-593-7944
Provider Business Practice Location Address
First Line : 6010 ERIN PARK DRIVE
Second Line : SUITE 2
City : COLORADO SPRINGS
State : CO
Zip : 80918-3431
Country : US
Telephone Number : 719-593-7942
Fax Number : 719-593-7944
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2006
Last Update Date : 07/08/2007

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