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General NPI Number Information
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NPI Number | 1144452772
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Entity Type | Organization
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Legal Business Name | STEFAN A. PLOSZAK DDS, PA
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Dates
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Enumeration Date | 08/15/2009
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Last Update Date | 08/15/2009
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Provider Practice Location Address
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Address Line | 3321 ZELDA LN
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City | MATTHEWS
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State | NC
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Zip | 28105-3888
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Country | US
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Telephone | 704-575-4268
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Fax |
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Provider Business Mailing Address
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Address Line | 3321 ZELDA LN
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City | MATTHEWS
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State | NC
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Zip | 28105-3888
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. STEFAN A. PLOSZAK
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Credential | DDS
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Telephone | 704-575-4268
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 8395
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License Number State | NC
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