MEDICARE: KULONGOWSKI AND ZIELINSKI DENTISTRY PARTNERSHIP

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	2901018397	MI

General Provider Information

NPI Number	:	1992759914
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KULONGOWSKI AND ZIELINSKI DENTISTRY PARTNERSHIP

Provider Business Mailing Address
First Line	:	124 N SAGINAW ST
Second Line	:	SUITE C
City	:	HOLLY
State	:	MI
Zip	:	48442-1405
Country	:	US
Telephone Number	:	248-634-1976
Fax Number	:	248-634-2414

Provider Business Practice Location Address
First Line	:	124 N SAGINAW ST
Second Line	:	SUITE C
City	:	HOLLY
State	:	MI
Zip	:	48442-1405
Country	:	US
Telephone Number	:	248-634-1976
Fax Number	:	248-634-2414

Authorized Official
Title or Position	:	OWNER
Name	:	DR. HEATHER LYNN HAYS ZIELINSKI
Credential	:	D.D.S.
Telephone Number	:	248-634-1976

Provider Enumeration Date	:	05/22/2006
Last Update Date	:	08/22/2020

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