Provider Demographics
NPI:1487793881
Name:ZIEGENHORN, DEZ (DDS)
Entity type:Individual
Prefix:DR
First Name:DEZ
Middle Name:
Last Name:ZIEGENHORN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 CENTRE PT
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63304-8519
Mailing Address - Country:US
Mailing Address - Phone:636-928-0144
Mailing Address - Fax:636-447-6605
Practice Address - Street 1:65 CENTRE PT
Practice Address - Street 2:SUITE 200
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63304-8519
Practice Address - Country:US
Practice Address - Phone:636-928-0144
Practice Address - Fax:636-447-6605
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005015582122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist