Individual
ROGER L ZIMMERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
464 S HICKORY ST, FOND DU LAC, WI 54935-5531
(920) 923-0111
(920) 923-0366
Mailing address
464 S HICKORY ST, FOND DU LAC, WI 54935-5531
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
5000111
WI
Other
Enumeration date
09/22/2006
Last updated
07/08/2007
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