Provider Demographics
NPI:1063124790
Name:JEFFREY L. ZANETTI DDS PC
Entity type:Organization
Organization Name:JEFFREY L. ZANETTI DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:L
Authorized Official - Last Name:ZANETTI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:248-477-1500
Mailing Address - Street 1:31904 GRAND RIVER AVE
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:48336-4126
Mailing Address - Country:US
Mailing Address - Phone:248-477-1500
Mailing Address - Fax:
Practice Address - Street 1:31904 GRAND RIVER AVE
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:MI
Practice Address - Zip Code:48336-4126
Practice Address - Country:US
Practice Address - Phone:248-477-1500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-13
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental