Provider Demographics
NPI:1316325160
Name:ZACHARY TAYLOR DDS PLLC
Entity type:Organization
Organization Name:ZACHARY TAYLOR DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:TUTTLE
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:801-792-4291
Mailing Address - Street 1:2675 CENTRAL AVE
Mailing Address - Street 2:SUITE 10
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-6686
Mailing Address - Country:US
Mailing Address - Phone:406-652-9204
Mailing Address - Fax:
Practice Address - Street 1:2675 CENTRAL AVE
Practice Address - Street 2:SUITE 10
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-6686
Practice Address - Country:US
Practice Address - Phone:406-652-9204
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-13
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTDENDENLIC95501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty