Provider Demographics
NPI:1912569799
Name:HUTCHINS, ZACHARY MARC
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:MARC
Last Name:HUTCHINS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25234 LAWTON AVE
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-3541
Mailing Address - Country:US
Mailing Address - Phone:714-909-4024
Mailing Address - Fax:
Practice Address - Street 1:1596 2ND AVE NE STE A
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MN
Practice Address - Zip Code:55008-8069
Practice Address - Country:US
Practice Address - Phone:763-689-5699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-02
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND14284122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist