Individual
RICHARD W ZIEGLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
6903 STANLEY AVE, BERWYN, IL 60402-2919
(708) 795-4288
Mailing address
6903 STANLEY AVE, BERWYN, IL 60402-2919
(708) 795-4288
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019-019096
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019-019096
—
IL
01
—
319-008545
CS LICENSE
IL
Enumeration date
06/10/2006
Last updated
03/07/2023
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