MEDICARE: ZACHARY DAN SOARD DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	6522	NV

General Provider Information

NPI Number	:	1194131011
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZACHARY DAN SOARD DMD

Provider Business Mailing Address
First Line	:	1306 W CRAIG RD STE H
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-0215
Country	:	US
Telephone Number	:	702-633-4333
Fax Number	:	702-639-0032

Provider Business Practice Location Address
First Line	:	1306 W CRAIG RD STE H
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-0215
Country	:	US
Telephone Number	:	702-633-4333
Fax Number	:	702-639-0032

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2014
Last Update Date	:	02/05/2022

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