Provider Demographics
NPI:1699830562
Name:ZAMANIGAN, TERRY RICHARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:RICHARD
Last Name:ZAMANIGAN
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 1:20881 BEACHWOOD LN
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92646-6328
Mailing Address - Country:US
Mailing Address - Phone:714-962-9308
Mailing Address - Fax:
Practice Address - Street 1:13275 SOUTH ST
Practice Address - Street 2:
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-7307
Practice Address - Country:US
Practice Address - Phone:562-924-8663
Practice Address - Fax:562-924-8890
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA230671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice