Provider Demographics
NPI:1225468143
Name:ZACHARY, CYNTHIA (RDH)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:
Last Name:ZACHARY
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 MAIN ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:DOWAGIAC
Mailing Address - State:MI
Mailing Address - Zip Code:49047-1762
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:520 MAIN ST
Practice Address - Street 2:SUITE B
Practice Address - City:DOWAGIAC
Practice Address - State:MI
Practice Address - Zip Code:49047-1762
Practice Address - Country:US
Practice Address - Phone:269-782-0064
Practice Address - Fax:269-782-0235
Is Sole Proprietor?:No
Enumeration Date:2013-11-13
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2902013892124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist