Provider Demographics
NPI:1467901959
Name:ZENGA, WILLIAM THOMAS JR
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:THOMAS
Last Name:ZENGA
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 N UNIVERSITY DR
Mailing Address - Street 2:SUITE 9
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33322-3003
Mailing Address - Country:US
Mailing Address - Phone:954-741-8580
Mailing Address - Fax:954-741-8585
Practice Address - Street 1:2500 N UNIVERSITY DR
Practice Address - Street 2:SUITE 9
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33322-3003
Practice Address - Country:US
Practice Address - Phone:954-741-8580
Practice Address - Fax:954-741-8585
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-26
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN21911122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist