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NPI Code Detail

MEDICARE: DR. MICHAEL STEWART ZOLA DMD

MEDICARE: DR. MICHAEL STEWART ZOLA DMD
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
11223G0001XGeneral Practice Dentistry034250CA

General Provider Information

NPI Number : 1700899184
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL STEWART ZOLA DMD
Provider Business Mailing Address
First Line : 1033 GAYLEY AVE
Second Line : SUITE 115
City : LOS ANGELES
State : CA
Zip : 90024-3417
Country : US
Telephone Number : 310-208-4036
Fax Number : 310-208-1344
Provider Business Practice Location Address
First Line : 1033 GAYLEY AVE
Second Line : SUITE 115
City : LOS ANGELES
State : CA
Zip : 90024-3417
Country : US
Telephone Number : 310-208-4036
Fax Number : 310-208-1344
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2006
Last Update Date : 07/08/2007

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