Provider Demographics
NPI:1922028836
Name:ZUNICH, CAROLYN M (DDS)
Entity Type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:M
Last Name:ZUNICH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1136 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:DETROIT LAKES
Mailing Address - State:MN
Mailing Address - Zip Code:56501-3411
Mailing Address - Country:US
Mailing Address - Phone:218-847-2624
Mailing Address - Fax:218-847-5792
Practice Address - Street 1:1136 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:DETROIT LAKES
Practice Address - State:MN
Practice Address - Zip Code:56501-3411
Practice Address - Country:US
Practice Address - Phone:218-847-2624
Practice Address - Fax:218-847-5792
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN12077122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist