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Individual
KEVIN JAMES ZIMMERMAN
Active
Individual
KEVIN JAMES ZIMMERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS035025
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
273855
—
OR
Enumeration date
08/28/2006
Last updated
10/30/2012
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