Provider Demographics
NPI:1669515599
Name:RICHARD ZIEGLER DDS, PC
Entity type:Organization
Organization Name:RICHARD ZIEGLER DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:ZIEGLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:708-795-4288
Mailing Address - Street 1:6903 STANLEY AVE
Mailing Address - Street 2:
Mailing Address - City:BERWYN
Mailing Address - State:IL
Mailing Address - Zip Code:60402-2919
Mailing Address - Country:US
Mailing Address - Phone:708-795-4288
Mailing Address - Fax:708-484-0668
Practice Address - Street 1:6903 STANLEY AVE
Practice Address - Street 2:
Practice Address - City:BERWYN
Practice Address - State:IL
Practice Address - Zip Code:60402-2919
Practice Address - Country:US
Practice Address - Phone:708-795-4288
Practice Address - Fax:708-484-0668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental