MEDICARE: ZACHARY ROBERT ROSS DDS

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	35405	TX

General Provider Information

NPI Number	:	1245891803
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZACHARY ROBERT ROSS DDS

Provider Business Mailing Address
First Line	:	650 HUEBNER RD
Second Line	:
City	:	FORT RILEY
State	:	KS
Zip	:	66442-4030
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9440 BATTALION AVE
Second Line	:
City	:	FORT HOOD
State	:	TX
Zip	:	76544
Country	:	US
Telephone Number	:	254-288-7863
Fax Number	:

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

Provider Enumeration Date	:	06/25/2019
Last Update Date	:	05/26/2026

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