Provider Demographics
NPI:1215317730
Name:ZIMMERMAN, EMMA (DMD)
Entity type:Individual
Prefix:DR
First Name:EMMA
Middle Name:
Last Name:ZIMMERMAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3950 VETERANS DRIVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ST. CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303
Mailing Address - Country:US
Mailing Address - Phone:320-253-8380
Mailing Address - Fax:230-253-8419
Practice Address - Street 1:3950 VETERANS DRIVE
Practice Address - Street 2:SUITE 102
Practice Address - City:ST. CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303
Practice Address - Country:US
Practice Address - Phone:320-253-8380
Practice Address - Fax:230-253-8419
Is Sole Proprietor?:No
Enumeration Date:2015-06-01
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MND135651223P0221X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry