Provider Demographics
NPI:1215174529
Name:ZENN, ROGER H (DDS)
Entity type:Individual
Prefix:DR
First Name:ROGER
Middle Name:H
Last Name:ZENN
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 1:123 COLUMBIA TPKE
Mailing Address - Street 2:SUITE 101-B
Mailing Address - City:FLORHAM PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07932-2117
Mailing Address - Country:US
Mailing Address - Phone:973-377-7007
Mailing Address - Fax:
Practice Address - Street 1:123 COLUMBIA TPKE
Practice Address - Street 2:SUITE 101-B
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-2117
Practice Address - Country:US
Practice Address - Phone:973-377-7007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-09
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ125091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice