Provider Demographics
NPI:1710407341
Name:ZC DENTISTRY LLC
Entity type:Organization
Organization Name:ZC DENTISTRY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:D
Authorized Official - Last Name:CHRISTOPHERSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:307-426-4014
Mailing Address - Street 1:4000 LARAMIE STREET
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001
Mailing Address - Country:US
Mailing Address - Phone:307-426-4014
Mailing Address - Fax:307-426-4016
Practice Address - Street 1:4000 LARAMIE STREET
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001
Practice Address - Country:US
Practice Address - Phone:307-426-4014
Practice Address - Fax:307-426-4016
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ZC DENTISTRY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-06-24
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY1473261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental