DR. Zachary Ickes, D.D.S.

NPI #1790212504 in Defiance, Ohio

Provider Information

NPI Number: 1790212504
Entity Type: Individual
Name: DR. Zachary Ickes, D.D.S.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: D.D.S.
Enumeration Date: May 11, 2017
Last Updated: May 11, 2017

Practice Location

Address: 1601 N CLINTON ST
Address 2: SUITE A
City: Defiance
State: Ohio
ZIP Code: 43512-8551
Phone: (419) 956-0926

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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