Provider Demographics
NPI:1669834594
Name:KASHLAN, ZACHARIA (DMD)
Entity Type:Individual
Prefix:DR
First Name:ZACHARIA
Middle Name:
Last Name:KASHLAN
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 1:385 SADDLE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-1083
Mailing Address - Country:US
Mailing Address - Phone:678-982-8336
Mailing Address - Fax:
Practice Address - Street 1:385 SADDLE CREEK DR
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-1083
Practice Address - Country:US
Practice Address - Phone:678-982-8336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-21
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0151081223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics