Individual
DR. JASON A ZIMMERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.
Contact information
Practice address
4545 BELLAIRE DR S STE 4, FORT WORTH, TX 76109-1811
(214) 533-8183
(817) 796-2404
Mailing address
PO BOX 55367, HURST, TX 76054-5367
(214) 533-8183
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
20465
TX
1223P0221X
Pediatric Dentistry
Primary
20465
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
151049709
—
TX
Enumeration date
03/12/2006
Last updated
10/23/2022
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