MEDICARE: TAO ZHANG, DDS, LLC

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	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1356840045
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TAO ZHANG, DDS, LLC

Provider Business Mailing Address
First Line	:	3056 SEAWAY CT
Second Line	:
City	:	LEWIS CENTER
State	:	OH
Zip	:	43035-7996
Country	:	US
Telephone Number	:	614-962-1340
Fax Number	:

Provider Business Practice Location Address
First Line	:	1240 CRESCENT HEIGHTS RD
Second Line	:
City	:	MARION
State	:	OH
Zip	:	43302-6408
Country	:	US
Telephone Number	:	740-387-5196
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TAO ZHANG
Credential	:
Telephone Number	:	614-962-1340

Provider Enumeration Date	:	02/07/2018
Last Update Date	:	02/07/2018

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