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General NPI Number Information
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NPI Number | 1114467289
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Entity Type | Individual
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Provider Name | ZACHARY WILLIAM SCHURCH D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/08/2017
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Last Update Date | 01/13/2020
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Provider Practice Location Address
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Address Line | 57950 LEAVENWORTH ST BLDG 250
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City | MCCONNELL AFB
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State | KS
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Zip | 67221-3506
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Country | US
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Telephone | 316-759-5181
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Fax |
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Provider Business Mailing Address
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Address Line | 57950 LEAVENWORTH ST BLDG 250
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City | MCCONNELL AFB
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State | KS
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Zip | 67221-3506
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Country | US
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Telephone | 316-759-5181
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 8948
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License Number State | SC
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