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General NPI Number Information
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NPI Number | 1245675131
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Entity Type | Organization
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Legal Business Name | ZACHARY J. WESLEY DDS PLC
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Dates
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Enumeration Date | 05/06/2013
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Last Update Date | 05/06/2013
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Provider Practice Location Address
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Address Line | 761 OLD HICKORY BLVD STE 100
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City | BRENTWOOD
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State | TN
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Zip | 37027-4519
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Country | US
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Telephone | 615-377-0111
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Fax | 615-371-8089
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Provider Business Mailing Address
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Address Line | 761 OLD HICKORY BLVD STE 100
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City | BRENTWOOD
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State | TN
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Zip | 37027-4519
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Country | US
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Telephone | 615-377-0111
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Fax | 615-371-8089
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. ZACHARY J. WESLEY
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Credential | DDS
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Telephone | 615-377-0111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 8224
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License Number State | TN
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