Provider Demographics
NPI:1548237456
Name:ZEMENS, LISA (DDS)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:
Last Name:ZEMENS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30795 23 MILE RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48047-5720
Mailing Address - Country:US
Mailing Address - Phone:586-949-4630
Mailing Address - Fax:586-949-5325
Practice Address - Street 1:30795 23 MILE RD
Practice Address - Street 2:SUITE 203
Practice Address - City:CHESTERFIELD
Practice Address - State:MI
Practice Address - Zip Code:48047-5720
Practice Address - Country:US
Practice Address - Phone:586-949-4630
Practice Address - Fax:586-949-5325
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI169631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice