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General NPI Number Information
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NPI Number | 1043154677
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Entity Type | Organization
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Legal Business Name | OMC DENTAL, PLLC
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Dates
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Enumeration Date | 04/15/2026
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Last Update Date | 04/15/2026
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Provider Practice Location Address
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Address Line | 31904 GRAND RIVER AVE
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City | FARMINGTON
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State | MI
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Zip | 48336-4126
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Country | US
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Telephone | 248-477-1500
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Fax |
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Provider Business Mailing Address
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Address Line | 23641 WILMARTH AVE
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City | FARMINGTON
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State | MI
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Zip | 48335-3564
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Country | US
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Telephone | 248-396-7780
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Fax |
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Authorized Official
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Title or Position | MEMBER/OWNER
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Name | DR. OLIVIA CZAJKOWSKI
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Credential | DDS
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Telephone | 248-396-7780
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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