Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 4073015 | WI |
NPI | 1104936681 |
---|---|
Provider Name | Dr. Anthony Joseph Ziebert |
First Address | Milwaukee, WI 53202 |
Second Address | Milwaukee, WI 53202 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 08/07/2007 |