Provider Demographics
NPI:1699804971
Name:ZANETTI, JEFFREY LOUIS (DDS)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:LOUIS
Last Name:ZANETTI
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 1:31904 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:248-477-1569
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:248-477-1569
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010145081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice