| Zola Dental, Llc | |
|
1094 Royal Ct Medford OR 97504-6138 | |
| (541) 776-0050 | |
| Not Available |
| Full Name | Zola Dental, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1094 Royal Ct, Medford, Oregon |
| Authorized Official Name and Position | Anthony Mark Paventy (OWNER) |
| Authorized Official Contact | 5094755367 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Zola Dental, Llc 1094 Royal Ct Medford OR 97504-6138 Ph: (541) 776-0050 | Zola Dental, Llc 1094 Royal Ct Medford OR 97504-6138 Ph: (541) 776-0050 |
| NPI Number | 1295276913 |
|---|---|
| Provider Enumeration Date | 03/14/2017 |
| Last Update Date | 03/14/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295276913 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | D9209 (Oregon) | Primary |
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