Zwetchkenbaum, Samuel R.

Zwetchkenbaum, Samuel R. is an individual health care provider with primary practice located at 56 Woodbury St , Providence RI 02906-3510. He recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / Prosthodontics. Dental Providers / Dentist is his primary health care specialty. Zwetchkenbaum, Samuel R. can be contacted via phone (401) 588-1295.

Contact Information

Primary practice address
56 Woodbury St Providence RI 02906-3510
Phone: (401) 588-1295
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 2901016737 Michigan
Dental Providers / Dentist 122300000X 22DI01757400 New Jersey
Dental Providers / Prosthodontics 1223P0700X 22DI01757400 New Jersey
Dental Providers / Prosthodontics 1223P0700X 2901016737 Michigan
Dental Providers / Dentist 122300000X DEN02285 Rhode Island

Profile Details

NPI number 1871679415
LBN Legal business name Zwetchkenbaum, Samuel R.
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 27th, 2006
Last updated Sep 26th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871679415 NPPES
Michigan Other 00-D-16-7370-0 BCBSM
Michigan MEDICAID 4124472 BCBSM
Michigan MEDICAID 4124463 BCBSM

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