Provider Demographics
NPI:1801241518
Name:ZHANG, YAZHOU
Entity type:Individual
Prefix:
First Name:YAZHOU
Middle Name:
Last Name:ZHANG
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 1:136 MILL STREET
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:ME
Mailing Address - Zip Code:04668-3043
Mailing Address - Country:US
Mailing Address - Phone:207-796-5503
Mailing Address - Fax:207-483-2525
Practice Address - Street 1:136 MILL ST
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:ME
Practice Address - Zip Code:04668-3344
Practice Address - Country:US
Practice Address - Phone:207-796-5503
Practice Address - Fax:207-483-2525
Is Sole Proprietor?:No
Enumeration Date:2016-05-01
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEDEN4585122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist