| Zola Dental Medford Llc | |
|
922 E Main Medford OR 97504 | |
| (509) 475-5367 | |
| Not Available |
| Full Name | Zola Dental Medford Llc |
|---|---|
| Speciality | Dentist |
| Location | 922 E Main, 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 Medford Llc 922 E Main St Medford OR 97504-7136 Ph: () - | Zola Dental Medford Llc 922 E Main Medford OR 97504 Ph: (509) 475-5367 |
| NPI Number | 1437646908 |
|---|---|
| Provider Enumeration Date | 04/19/2018 |
| Last Update Date | 04/19/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437646908 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D9209 (Oregon) | Primary |
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