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General NPI Number Information
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NPI Number | 1700311883
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Entity Type | Individual
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Provider Name | MARY MACHOWSKI DMD
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Gender | Female
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Dates
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Enumeration Date | 04/26/2017
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Last Update Date | 08/07/2023
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Provider Practice Location Address
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Address Line | 13089 OCEAN HWY UNIT D4
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City | PAWLEYS ISLAND
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State | SC
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Zip | 29585-7140
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Country | US
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Telephone | 843-903-7767
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Fax |
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Provider Business Mailing Address
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Address Line | 1461 BROOKGREEN DR
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City | MYRTLE BEACH
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State | SC
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Zip | 29577-5823
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Country | US
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Telephone | 843-448-4163
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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 | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 9123
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 12185
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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