Provider Demographics
NPI:1922605302
Name:BENJAMIN L. ZARZECKI DDS PLLC
Entity Type:Organization
Organization Name:BENJAMIN L. ZARZECKI DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZARZECKI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:231-734-5621
Mailing Address - Street 1:PO BOX 687
Mailing Address - Street 2:
Mailing Address - City:EVART
Mailing Address - State:MI
Mailing Address - Zip Code:49631-0687
Mailing Address - Country:US
Mailing Address - Phone:231-734-5621
Mailing Address - Fax:231-734-5851
Practice Address - Street 1:120 N PINE ST
Practice Address - Street 2:
Practice Address - City:EVART
Practice Address - State:MI
Practice Address - Zip Code:49631-5120
Practice Address - Country:US
Practice Address - Phone:231-734-5621
Practice Address - Fax:231-734-5851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-08
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental