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NPI Code Detail

MEDICARE: DR. BRIAN JAMES ZIRKLE D.D.S.

MEDICARE: DR. BRIAN JAMES ZIRKLE 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
1122300000XDentist2901021248MI

General Provider Information

NPI Number : 1487055760
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRIAN JAMES ZIRKLE D.D.S.
Provider Business Mailing Address
First Line : 6922 CORRIGAN DR
Second Line :
City : BRIGHTON
State : MI
Zip : 48116-8852
Country : US
Telephone Number : 517-375-5099
Fax Number :
Provider Business Practice Location Address
First Line : 2228 W GRAND RIVER AVE
Second Line :
City : OKEMOS
State : MI
Zip : 48864-1604
Country : US
Telephone Number : 517-347-0034
Fax Number : 517-347-9708
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/05/2014
Last Update Date : 11/16/2019

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