Provider Demographics
NPI:1023014040
Name:ZIEMLAK, CASMER C JR (DDS)
Entity Type:Individual
Prefix:
First Name:CASMER
Middle Name:C
Last Name:ZIEMLAK
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:198 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:MA
Mailing Address - Zip Code:01749-2732
Mailing Address - Country:US
Mailing Address - Phone:978-562-9101
Mailing Address - Fax:
Practice Address - Street 1:198 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:MA
Practice Address - Zip Code:01749-2732
Practice Address - Country:US
Practice Address - Phone:978-562-9101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA112851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice