Provider Demographics
NPI:1497170864
Name:ZEILLEMAKER, CHRISTINE (RDHAP #508)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:
Last Name:ZEILLEMAKER
Suffix:
Gender:F
Credentials:RDHAP #508
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7887 OLIVE ST
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628-5808
Mailing Address - Country:US
Mailing Address - Phone:916-531-4456
Mailing Address - Fax:
Practice Address - Street 1:7887 OLIVE ST
Practice Address - Street 2:
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-5808
Practice Address - Country:US
Practice Address - Phone:916-531-4456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-21
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA508124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist