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General NPI Number Information
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NPI Number | 1649237686
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Entity Type | Individual
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Provider Name | ZACHARY HARRIS BRUMBACH DDS
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Gender | Male
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Dates
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Enumeration Date | 04/26/2006
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Last Update Date | 11/24/2010
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Provider Practice Location Address
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Address Line | 609 CALGARY CT. SUITE 104
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City | POST FALLS
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State | ID
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Zip | 83854
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Country | US
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Telephone | 208-777-1222
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Fax |
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Provider Business Mailing Address
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Address Line | 609 N CALGARY CT STE 104
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City | POST FALLS
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State | ID
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Zip | 83854-4906
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Country | US
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Telephone | 208-777-1222
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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 | D-8344
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License Number State | OR
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