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NPI Code Detail

MEDICARE: KENNETH J. WOLNIK, DDS INC

MEDICARE: KENNETH J. WOLNIK, DDS INC
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
11223G0001XGeneral Practice Dentistry21692OH

General Provider Information

NPI Number : 1497967822
Entity Type Code : Organization
Provider Name (Legal Business Name) : KENNETH J. WOLNIK, DDS INC
Provider Business Mailing Address
First Line : 6363 YORK RD
Second Line : SUITE 202
City : PARMA HEIGHTS
State : OH
Zip : 44130-3031
Country : US
Telephone Number : 440-888-5055
Fax Number : 440-888-0249
Provider Business Practice Location Address
First Line : 6363 YORK RD
Second Line : SUITE 202
City : PARMA HEIGHTS
State : OH
Zip : 44130-3031
Country : US
Telephone Number : 440-888-5055
Fax Number : 440-888-0249
Authorized Official
Title or Position : PRESIDENT
Name : KENNETH J WOLNIK II
Credential : D.D.S.
Telephone Number : 440-888-5055
Provider Enumeration Date : 05/06/2007
Last Update Date : 10/03/2014

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Directions to “KENNETH J. WOLNIK, DDS INC ” Practice Location

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