Provider Demographics
NPI:1669848503
Name:MICHAEL ZINGALIS DDS PA
Entity Type:Organization
Organization Name:MICHAEL ZINGALIS DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ZINGALIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-656-0572
Mailing Address - Street 1:2250 THOUSAND OAKS DR
Mailing Address - Street 2:SUITE #120
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-3989
Mailing Address - Country:US
Mailing Address - Phone:210-314-6635
Mailing Address - Fax:
Practice Address - Street 1:25135 CALLAWAY
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78260-7255
Practice Address - Country:US
Practice Address - Phone:832-656-0572
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-14
Last Update Date:2015-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX202581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty