Provider Demographics
NPI:1942652797
Name:VANCE, ZACHARY BRYAN (DDS)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:BRYAN
Last Name:VANCE
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 1:209 MONTLIEU AVE
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-4030
Mailing Address - Country:US
Mailing Address - Phone:704-929-8573
Mailing Address - Fax:
Practice Address - Street 1:633 HOPKINS RD
Practice Address - Street 2:
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-9379
Practice Address - Country:US
Practice Address - Phone:336-996-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-05
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC103771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice