Provider Demographics
NPI:1639275043
Name:ZINDERMAN, ROBERT WADE (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:WADE
Last Name:ZINDERMAN
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 1:117 ELISA LANDI DR
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-7408
Mailing Address - Country:US
Mailing Address - Phone:845-339-4974
Mailing Address - Fax:845-339-1195
Practice Address - Street 1:273 HURLEY AVE
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-2421
Practice Address - Country:US
Practice Address - Phone:845-339-4100
Practice Address - Fax:845-339-1195
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYD282031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice