Provider Demographics
NPI:1740313451
Name:DONALD G. ZUNDEL, DDS,LTD
Entity type:Organization
Organization Name:DONALD G. ZUNDEL, DDS,LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:G
Authorized Official - Last Name:ZUNDEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:775-825-2954
Mailing Address - Street 1:630 SIERRA ROSE DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-2072
Mailing Address - Country:US
Mailing Address - Phone:775-825-2954
Mailing Address - Fax:775-825-5924
Practice Address - Street 1:630 SIERRA ROSE DR
Practice Address - Street 2:SUITE B
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-2072
Practice Address - Country:US
Practice Address - Phone:775-825-2954
Practice Address - Fax:775-825-5924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV500302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization