Provider Demographics
NPI:1033221684
Name:POWELL, ZACHARY JOSEPH (DMD)
Entity Type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:JOSEPH
Last Name:POWELL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2395 MANOR CREEK CT
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-9796
Mailing Address - Country:US
Mailing Address - Phone:770-205-8703
Mailing Address - Fax:
Practice Address - Street 1:980 SANDERS RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-5960
Practice Address - Country:US
Practice Address - Phone:770-205-3111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA012013122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist