NPI 1043319056

Roger L Zimmerman, DDS

Practitioner Oral and Maxillofacial Pathology Dentistry Fond Du Lac, WI

Practice location

Address: 464 S Hickory St, Fond Du Lac, WI 54935-5531
Phone: (920) 923-0111
Fax: (920) 923-0366

Registered specialties

Oral and Maxillofacial Pathology Dentistry Primary

Dental Providers Taxonomy 1223P0106X Licence 5000111 (WI)

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Registry record

NPI: 1043319056
Entity type: Individual
Sex (as registered): Male
NPI issued: 22 Sep 2006
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.