Provider Demographics
NPI:1508840554
Name:ZIEGLER, LORRAINE F (RDH)
Entity Type:Individual
Prefix:
First Name:LORRAINE
Middle Name:F
Last Name:ZIEGLER
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 N CENTROL FAMILIAR SW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87105
Mailing Address - Country:US
Mailing Address - Phone:508-833-0024
Mailing Address - Fax:505-873-7473
Practice Address - Street 1:111 COORS BLVD NW
Practice Address - Street 2:SUITE E1
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87121-2006
Practice Address - Country:US
Practice Address - Phone:505-833-0024
Practice Address - Fax:505-873-7473
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDH457124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist