Provider Demographics
NPI:1841462082
Name:ZACHARY P. HAIRSTON, D.D.S., P.C
Entity type:Organization
Organization Name:ZACHARY P. HAIRSTON, D.D.S., P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:P
Authorized Official - Last Name:HAIRSTON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:434-792-0700
Mailing Address - Street 1:190 WATSON ST
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-2835
Mailing Address - Country:US
Mailing Address - Phone:434-792-0700
Mailing Address - Fax:434-792-5325
Practice Address - Street 1:190 WATSON ST
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-2835
Practice Address - Country:US
Practice Address - Phone:434-792-0700
Practice Address - Fax:434-792-5325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-27
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010061551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty