Provider Demographics
NPI:1871005603
Name:PHILIP J. ZNIDARSIC DDS, LLC
Entity Type:Organization
Organization Name:PHILIP J. ZNIDARSIC DDS, LLC
Other - Org Name:NORDONIA DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:ZNIDARSIC
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:330-467-6466
Mailing Address - Street 1:147 E AURORA RD
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44067-2084
Mailing Address - Country:US
Mailing Address - Phone:330-467-6466
Mailing Address - Fax:
Practice Address - Street 1:147 E AURORA RD
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:OH
Practice Address - Zip Code:44067-2084
Practice Address - Country:US
Practice Address - Phone:330-467-6466
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-02
Last Update Date:2017-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty