Provider Demographics
NPI:1669857504
Name:TEACH, ZACHARY ADAM (DDS)
Entity Type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:ADAM
Last Name:TEACH
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 1:1281 UNION RD
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-2900
Mailing Address - Country:US
Mailing Address - Phone:716-675-3163
Mailing Address - Fax:716-675-3164
Practice Address - Street 1:1281 UNION RD
Practice Address - Street 2:
Practice Address - City:WEST SENECA
Practice Address - State:NY
Practice Address - Zip Code:14224-2900
Practice Address - Country:US
Practice Address - Phone:716-675-3163
Practice Address - Fax:716-675-3164
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-21
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY057982-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice