Provider Demographics
NPI:1710017892
Name:ZELLMER, JUSTIN ANDREW (DMD)
Entity Type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:ANDREW
Last Name:ZELLMER
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 1:5529 COLONY LN
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35226-5058
Mailing Address - Country:US
Mailing Address - Phone:205-989-8512
Mailing Address - Fax:205-621-6212
Practice Address - Street 1:101 HIGHWAY 87
Practice Address - Street 2:BUILDING 300
Practice Address - City:CALERA
Practice Address - State:AL
Practice Address - Zip Code:35040-7209
Practice Address - Country:US
Practice Address - Phone:205-664-1190
Practice Address - Fax:205-621-6212
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL52081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice