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NPI Code Detail

MEDICARE: DR. SUSAN L ZUNT DDS MS

MEDICARE: DR. SUSAN L ZUNT 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
11223P0106XOral and Maxillofacial Pathology Dentistry12008168IN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000000189273OTHERANTHEM

General Provider Information

NPI Number : 1245205392
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SUSAN L ZUNT DDS MS
Provider Business Mailing Address
First Line : 1121 WEST MICHIGAN STREET
Second Line : ROOM 285
City : INDIANAPOLIS
State : IN
Zip : 46202-5211
Country : US
Telephone Number : 317-274-7668
Fax Number : 317-274-3346
Provider Business Practice Location Address
First Line : 1121 WEST MICHIGAN STREET
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46202-5211
Country : US
Telephone Number : 317-274-7668
Fax Number : 317-274-3346
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2006
Last Update Date : 07/08/2007

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