Healthcare Provider Details

I. General information

NPI: 1467288910
Provider Name (Legal Business Name): ZAPATAENDO PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2024
Last Update Date: 09/11/2024
Certification Date: 09/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1821 N TREKELL RD STE 6
CASA GRANDE AZ
85122-1705
US

IV. Provider business mailing address

2870 N CAMINO DE OESTE
TUCSON AZ
85745-9201
US

V. Phone/Fax

Practice location:
  • Phone: 520-552-6446
  • Fax:
Mailing address:
  • Phone: 520-991-9061
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: THOMAS PAUL SCHUH
Title or Position: OWNER
Credential: DMD
Phone: 520-991-9061