Individual
JEFFREY FRANK ZIEZIULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4901 N TRYON ST, CHARLOTTE, NC 28213-7033
(704) 921-0204
(704) 921-4095
Mailing address
4901 N TRYON ST, CHARLOTTE, NC 28213-7076
(704) 921-0204
(704) 921-4095
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7670
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89-902PK
—
NC
01
—
902PK
BLUE CROSS BLUE SHIELD NC
—
Enumeration date
08/25/2006
Last updated
05/17/2013
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