Provider Demographics
NPI:1497423610
Name:DAVIS, ZACHARY ALAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:ALAN
Last Name:DAVIS
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 1:223 E TOWN ST STE 203
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-4683
Mailing Address - Country:US
Mailing Address - Phone:330-321-9114
Mailing Address - Fax:
Practice Address - Street 1:9420 DAYTON LEBANON PIKE
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45458-3860
Practice Address - Country:US
Practice Address - Phone:877-959-5405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-01
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0266351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice