Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 3876-016 | WI |
NPI | 1043299779 |
---|---|
Provider Name | Melinda L Zufall |
First Address | Prairie Du Sac, WI 53578-2041 |
Second Address | Prairie Du Sac, WI 53578-2041 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2006 |
Last Update Date | 08/07/2007 |