Individual
PERIZA ZANINOVIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
123 MARMONT STREET, NILES, MI 49120
(512) 931-2190
(512) 869-2940
Mailing address
123 MARMONT STREET, NILES, MI 49120
(512) 931-2190
(512) 869-2940
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901600691
MI
1223G0001X
General Practice Dentistry
20101
TX
1223G0001X
General Practice Dentistry
473472
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
47342
STATE LICENSE NUMBER
CA
Enumeration date
04/26/2007
Last updated
10/13/2020
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