Provider Demographics
NPI:1578568861
Name:ZIEGLER, RICHARD C (DDS)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:C
Last Name:ZIEGLER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4447 TALMADGE RD
Mailing Address - Street 2:STE A
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-3517
Mailing Address - Country:US
Mailing Address - Phone:419-479-3939
Mailing Address - Fax:419-479-3933
Practice Address - Street 1:4447 TALMADGE RD
Practice Address - Street 2:STE A
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-3517
Practice Address - Country:US
Practice Address - Phone:419-479-3939
Practice Address - Fax:419-479-3933
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH172661223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0515606Medicaid
OH0515606Medicaid
OHT47883Medicare UPIN