Provider Demographics
NPI:1285143990
Name:SIEFRING, ZACHARY DAVID (DMD)
Entity type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:DAVID
Last Name:SIEFRING
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 BUR OAK DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45331-4307
Mailing Address - Country:US
Mailing Address - Phone:419-953-2548
Mailing Address - Fax:
Practice Address - Street 1:440 BUR OAK DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:OH
Practice Address - Zip Code:45331-4307
Practice Address - Country:US
Practice Address - Phone:937-548-5496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-26
Last Update Date:2019-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.025170122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist