Provider Demographics
NPI:1578005310
Name:WILLIAM THOMAS ZENGA, DMD, PA
Entity Type:Organization
Organization Name:WILLIAM THOMAS ZENGA, DMD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:ZENGA
Authorized Official - Suffix:JR
Authorized Official - Credentials:DMD
Authorized Official - Phone:954-741-8580
Mailing Address - Street 1:2500 N UNIVERSITY DR
Mailing Address - Street 2:SUITE 9
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33322-3003
Mailing Address - Country:US
Mailing Address - Phone:954-741-8580
Mailing Address - Fax:954-741-8585
Practice Address - Street 1:2500 N UNIVERSITY DR
Practice Address - Street 2:SUITE 9
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33322-3003
Practice Address - Country:US
Practice Address - Phone:954-741-8580
Practice Address - Fax:954-741-8585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-10
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN219111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty