Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | DN0012231 | FL |
NPI | 1154455277 |
---|---|
Provider Name | Dr. John D Zongker |
First Address | Jacksonville, FL 32256-7909 |
Second Address | Jacksonville, FL 32256-7909 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2007 |
Last Update Date | 08/07/2007 |