MEDICARE: DR. ANDREW STEPHEN ZALE D.M.D.

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	1223P0221X	Pediatric Dentistry	DS038997	PA
2	1223P0221X	Pediatric Dentistry	D008923	AZ

General Provider Information

NPI Number	:	1568775591
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW STEPHEN ZALE D.M.D.

Provider Business Mailing Address
First Line	:	839 W CONGRESS ST
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85745-2819
Country	:	US
Telephone Number	:	520-670-3909
Fax Number	:	520-309-2560

Provider Business Practice Location Address
First Line	:	716 N COUNTRY CLUB RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85716-4506
Country	:	US
Telephone Number	:	520-326-8516
Fax Number	:

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

Provider Enumeration Date	:	07/19/2010
Last Update Date	:	03/25/2025

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