Provider Demographics
NPI:1114687720
Name:ZANG-BODIS ORTHODONTICS PLLC
Entity Type:Organization
Organization Name:ZANG-BODIS ORTHODONTICS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZANG-BODIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-395-7375
Mailing Address - Street 1:4274 SUGAR MAPLE LN
Mailing Address - Street 2:
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48864-3225
Mailing Address - Country:US
Mailing Address - Phone:734-395-7375
Mailing Address - Fax:
Practice Address - Street 1:1866 HASLETT RD STE 1
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-6927
Practice Address - Country:US
Practice Address - Phone:734-395-7375
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-22
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty