Provider Demographics
NPI:1780193409
Name:ZACHARY D. SIEFRING DMD, INC.
Entity Type:Organization
Organization Name:ZACHARY D. SIEFRING DMD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:SIEFRING
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:419-953-2548
Mailing Address - Street 1:440 BUR OAK DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45331-4307
Mailing Address - Country:US
Mailing Address - Phone:419-953-2548
Mailing Address - Fax:
Practice Address - Street 1:440 BUR OAK DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:OH
Practice Address - Zip Code:45331-4307
Practice Address - Country:US
Practice Address - Phone:937-548-5496
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-26
Last Update Date:2019-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental