Provider Demographics
NPI:1487263125
Name:T RICHARD ZIEHMER DDS MSD PLLC
Entity type:Organization
Organization Name:T RICHARD ZIEHMER DDS MSD PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:CANOVALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-331-3627
Mailing Address - Street 1:4016 BATTLEGROUND AVE STE H
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-9800
Mailing Address - Country:US
Mailing Address - Phone:336-285-7177
Mailing Address - Fax:
Practice Address - Street 1:4016 BATTLEGROUND AVE STE H
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-9800
Practice Address - Country:US
Practice Address - Phone:336-285-7177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-29
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty