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General NPI Number Information
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NPI Number | 1629190541
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Entity Type | Organization
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Legal Business Name | ZELAZNY FAMILY DENTISTRY
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 10128 BROOK RD
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City | GLEN ALLEN
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State | VA
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Zip | 23059-6514
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Country | US
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Telephone | 804-627-0215
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Fax | 804-627-0217
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Provider Business Mailing Address
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Address Line | 10128 BROOK RD
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City | GLEN ALLEN
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State | VA
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Zip | 23059-6514
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Country | US
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Telephone | 804-627-0215
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Fax | 804-627-0217
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Authorized Official
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Title or Position | OWNER-DENTIST
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Name | DR. LLOYD JAMES ZELAZNY
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Credential | D.D.S.
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Telephone | 804-627-0215
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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 | 0401008890
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 0401008874
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License Number State | VA
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