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General NPI Number Information
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NPI Number | 1568039162
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Entity Type | Individual
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Provider Name | ZACHARY CASE DDS
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Gender | Male
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Dates
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Enumeration Date | 06/10/2021
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Last Update Date | 06/10/2021
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Provider Practice Location Address
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Address Line | 1840 E MAIN ST STE 1
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City | ONALASKA
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State | WI
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Zip | 54650-7710
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Country | US
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Telephone | 608-783-1306
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Fax |
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Provider Business Mailing Address
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Address Line | 1614 PRAIRIE PL APT 201
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City | HOLMEN
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State | WI
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Zip | 54636-5326
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Country | US
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Telephone |
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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 | 1002556
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License Number State | WI
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