Provider Demographics
NPI:1588018444
Name:ZIEMAN, MATTHEW THURSTON (DMD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:THURSTON
Last Name:ZIEMAN
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 1:5901 GRELOT ROAD, BUILDING C
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36609-3603
Mailing Address - Country:US
Mailing Address - Phone:251-344-6191
Mailing Address - Fax:254-344-6794
Practice Address - Street 1:5901 GRELOT ROAD, BUILDING C
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-3603
Practice Address - Country:US
Practice Address - Phone:251-344-6191
Practice Address - Fax:254-344-6794
Is Sole Proprietor?:No
Enumeration Date:2016-04-18
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL63181223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery