Healthcare Provider Details

I. General information

NPI: 1518897453
Provider Name (Legal Business Name): ZACHARY MICHAEL EARLL DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1008 MAIN ST
ONALASKA WI
54650-2741
US

IV. Provider business mailing address

1008 MAIN ST
ONALASKA WI
54650-2741
US

V. Phone/Fax

Practice location:
  • Phone: 608-783-3341
  • Fax:
Mailing address:
  • Phone: 608-783-3341
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number6002170-15
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: