Provider Demographics
NPI:1124742119
Name:ZACHARY N. STEFAN, DMD, LLC
Entity type:Organization
Organization Name:ZACHARY N. STEFAN, DMD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:
Authorized Official - Last Name:STEFAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-933-7045
Mailing Address - Street 1:1695 GLENN AVE APT A
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212-2348
Mailing Address - Country:US
Mailing Address - Phone:330-933-7045
Mailing Address - Fax:
Practice Address - Street 1:54 WESTERVIEW DR
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-2682
Practice Address - Country:US
Practice Address - Phone:614-794-3629
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental