Provider Demographics
NPI:1396818357
Name:WESLEY, ZACHARY J (DDS)
Entity Type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:J
Last Name:WESLEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:761 OLD HICKORY BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-4513
Mailing Address - Country:US
Mailing Address - Phone:615-377-0111
Mailing Address - Fax:615-371-8089
Practice Address - Street 1:761 OLD HICKORY BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-4513
Practice Address - Country:US
Practice Address - Phone:615-377-0111
Practice Address - Fax:615-371-8089
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TND82241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice