Individual
KEVIN JAMES ZIMMERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1270 KOT NUM ROAD, WARM SPRINGS, OR 97761-1209
(541) 553-1196
(541) 553-2135
Mailing address
1270 KOT NUM ROAD, PO BOX 1209, WARM SPRINGS, OR 97761-1209
(541) 553-1196
(541) 553-2135
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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