Individual
SAMANTHA RENEE ZACIEWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
27 ST LAWRENCE DR, SUITE 109, TIFFIN, OH 44883-8312
(419) 447-7337
Mailing address
27 ST LAWRENCE DR, SUITE 109, TIFFIN, OH 44883-8312
(419) 447-7337
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30-022212
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04968
PARAMOUNT
OH
05
—
2624815
—
OH
01
—
9182269
DORAL
OH
Enumeration date
01/25/2007
Last updated
07/06/2015
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