Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 30.025770 | OH |
NPI | 1114336815 |
---|---|
Provider Name | Fengyuan Zheng |
First Address | Dublin, OH 43017-2438 |
Second Address | Columbus, OH 43210-1267 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2014 |
Last Update Date | 18/11/2019 |