Provider Demographics
NPI:1376562777
Name:ZIMMERMANN, ERICH (DDS)
Entity Type:Individual
Prefix:DR
First Name:ERICH
Middle Name:
Last Name:ZIMMERMANN
Suffix:
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 1:205 S GARRISON ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-2843
Mailing Address - Country:US
Mailing Address - Phone:303-232-2873
Mailing Address - Fax:303-232-6957
Practice Address - Street 1:205 S GARRISON ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80226-2843
Practice Address - Country:US
Practice Address - Phone:303-232-2873
Practice Address - Fax:303-232-6957
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCO85601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice