Provider Demographics
NPI:1407859150
Name:WILLIAM ZUCKER & KENNETH WYNESKI, DENTAL PARTNERS, INC.
Entity Type:Organization
Organization Name:WILLIAM ZUCKER & KENNETH WYNESKI, DENTAL PARTNERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:ZUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:419-626-8853
Mailing Address - Street 1:3708 COLUMBUS AVE
Mailing Address - Street 2:STE 10
Mailing Address - City:SANDUSKY
Mailing Address - State:OH
Mailing Address - Zip Code:44870-5776
Mailing Address - Country:US
Mailing Address - Phone:419-686-8853
Mailing Address - Fax:419-625-8023
Practice Address - Street 1:3708 COLUMBUS AVE
Practice Address - Street 2:STE 10
Practice Address - City:SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:44870-5776
Practice Address - Country:US
Practice Address - Phone:419-686-8853
Practice Address - Fax:419-625-8023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental