Provider Demographics
NPI:1518577329
Name:ZIMMERMAN, FRANK HENRY (DMD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:HENRY
Last Name:ZIMMERMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12868 BAY PLANTATION DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32223-0784
Mailing Address - Country:US
Mailing Address - Phone:904-200-0319
Mailing Address - Fax:
Practice Address - Street 1:3676 CROWN POINT CT
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32257-5966
Practice Address - Country:US
Practice Address - Phone:904-268-2011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-06
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN253521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice