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General NPI Number Information
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NPI Number | 1073660593
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Entity Type | Individual
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Provider Name | ANTHONY BERNARD WOJCIK D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 01/05/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 52131 VAN DYKE AVE
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City | SHELBY TOWNSHIP
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State | MI
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Zip | 48316-3529
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Country | US
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Telephone | 586-739-6363
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Fax | 586-739-6473
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Provider Business Mailing Address
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Address Line | 8799 ESSEN DR
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City | STERLING HEIGHTS
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State | MI
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Zip | 48314-1650
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Country | US
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Telephone | 586-731-4216
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 2901017211
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License Number State | MI
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