Provider Demographics
NPI:1538132550
Name:KMZ DDS APDC
Entity Type:Organization
Organization Name:KMZ DDS APDC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KARL
Authorized Official - Middle Name:M
Authorized Official - Last Name:ZANDER
Authorized Official - Suffix:III
Authorized Official - Credentials:DDS
Authorized Official - Phone:916-391-4848
Mailing Address - Street 1:905 SECRET RIVER DR
Mailing Address - Street 2:STE C
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95831
Mailing Address - Country:US
Mailing Address - Phone:916-391-4848
Mailing Address - Fax:916-421-7931
Practice Address - Street 1:905 SECRET RIVER DR
Practice Address - Street 2:STE C
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95831
Practice Address - Country:US
Practice Address - Phone:916-391-4848
Practice Address - Fax:916-421-7931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-09
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA501231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty