Provider Demographics
NPI:1578330494
Name:ZACHARY W MCMILLAN DMD LLC
Entity Type:Organization
Organization Name:ZACHARY W MCMILLAN DMD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:MCMILLAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:843-340-5847
Mailing Address - Street 1:7610 COTESWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29572-4150
Mailing Address - Country:US
Mailing Address - Phone:843-340-5847
Mailing Address - Fax:
Practice Address - Street 1:304 79TH AVE N
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29572-4304
Practice Address - Country:US
Practice Address - Phone:843-449-4812
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty