MEDICARE: DR. DANIEL ZUNITCH 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	1223G0001X	General Practice Dentistry	DN011404	GA

General Provider Information

NPI Number	:	1386890424
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL ZUNITCH D.D.S

Provider Business Mailing Address
First Line	:	2458 WESLEY CHAPEL RD
Second Line	:	SUITE B
City	:	DECATUR
State	:	GA
Zip	:	30035-3423
Country	:	US
Telephone Number	:	770-322-0059
Fax Number	:	770-322-0509

Provider Business Practice Location Address
First Line	:	2458 WESLEY CHAPEL RD
Second Line	:	SUITE B
City	:	DECATUR
State	:	GA
Zip	:	30035-3423
Country	:	US
Telephone Number	:	770-322-0059
Fax Number	:	770-322-0509

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

Provider Enumeration Date	:	08/08/2008
Last Update Date	:	08/11/2008

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