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General NPI Number Information
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NPI Number | 1578613592
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Entity Type | Individual
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Provider Name | WILLIAM RAY DZYAK D.D.S.,P.C.
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Gender | Male
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 10605 CONCORD ST SUITE NUMBER 200
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City | KENSINGTON
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State | MD
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Zip | 20895-2504
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Country | US
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Telephone | 301-942-4900
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Fax |
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Provider Business Mailing Address
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Address Line | 10605 CONCORD ST
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City | KENSINGTON
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State | MD
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Zip | 20895-2504
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Country | US
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Telephone | 301-942-4900
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 8207
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License Number State | MD
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