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NPI Code Detail

MEDICARE: DR. STEVEN RALPH KINZIGER D.D.S.

MEDICARE: DR. STEVEN RALPH KINZIGER 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
11223G0001XGeneral Practice Dentistry3171-015WI

General Provider Information

NPI Number : 1871534388
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEVEN RALPH KINZIGER D.D.S.
Provider Business Mailing Address
First Line : W6376 GROVE ST
Second Line :
City : FOND DU LAC
State : WI
Zip : 54935-4706
Country : US
Telephone Number : 920-921-0918
Fax Number : 920-921-0918
Provider Business Practice Location Address
First Line : 545 E JOHNSON ST
Second Line :
City : FOND DU LAC
State : WI
Zip : 54935-2856
Country : US
Telephone Number : 920-924-9090
Fax Number : 920-921-0800
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2006
Last Update Date : 07/08/2007

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