Provider Demographics
NPI:1508829441
Name:OSBORNE, ZANE AUBREY (DDS)
Entity Type:Individual
Prefix:DR
First Name:ZANE
Middle Name:AUBREY
Last Name:OSBORNE
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 1:2104 ASHMUN ST
Mailing Address - Street 2:
Mailing Address - City:SAULT SAINTE MARIE
Mailing Address - State:MI
Mailing Address - Zip Code:49783-3703
Mailing Address - Country:US
Mailing Address - Phone:906-635-1541
Mailing Address - Fax:906-635-9461
Practice Address - Street 1:2104 ASHMUN ST
Practice Address - Street 2:
Practice Address - City:SAULT SAINTE MARIE
Practice Address - State:MI
Practice Address - Zip Code:49783-3703
Practice Address - Country:US
Practice Address - Phone:906-635-1541
Practice Address - Fax:906-635-9461
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI290100093721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice