Provider Demographics
NPI:1861879520
Name:MILLS, ZACHARY (DMD)
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:
Last Name:MILLS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 WOODCREST DR APT 10
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14625-2121
Mailing Address - Country:US
Mailing Address - Phone:315-396-1091
Mailing Address - Fax:
Practice Address - Street 1:770 FETZNER RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-1848
Practice Address - Country:US
Practice Address - Phone:315-396-1091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-01
Last Update Date:2019-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0593101223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry