Healthcare Provider Details

I. General information

NPI: 1326372319
Provider Name (Legal Business Name): ZACHARY JAMES BEECROFT D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ZACHARY J. BEECROFT D.D.S.

II. Dates (important events)

Enumeration Date: 09/24/2009
Last Update Date: 04/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6703 S. LOUISE AVE
SIOUX FALLS SD
57108
US

IV. Provider business mailing address

6703 S LOUISE AVE
SIOUX FALLS SD
57108
US

V. Phone/Fax

Practice location:
  • Phone: 605-271-9330
  • Fax: 605-271-9331
Mailing address:
  • Phone: 605-271-9330
  • Fax: 605-271-9331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberD0919
License Number StateSD
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberD0919
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: