Provider Demographics
NPI:1003565086
Name:PERIZA ZANINOVIC DDS PC
Entity Type:Organization
Organization Name:PERIZA ZANINOVIC DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PERIZA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZANINOVIC
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:269-683-6461
Mailing Address - Street 1:123 MARMONT ST
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:MI
Mailing Address - Zip Code:49120-1657
Mailing Address - Country:US
Mailing Address - Phone:269-683-6461
Mailing Address - Fax:
Practice Address - Street 1:123 MARMONT ST
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:MI
Practice Address - Zip Code:49120-1657
Practice Address - Country:US
Practice Address - Phone:269-683-6461
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-18
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty