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NPI Code Detail

MEDICARE: GREGORY M OKONIEWSKI PLLC

MEDICARE: GREGORY M OKONIEWSKI PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223D0001XPublic Health Dentistry

General Provider Information

NPI Number : 1033866694
Entity Type Code : Organization
Provider Name (Legal Business Name) : GREGORY M OKONIEWSKI PLLC
Provider Business Mailing Address
First Line : 3916 AUBURN RD STE 100
Second Line :
City : AUBURN HILLS
State : MI
Zip : 48326-3322
Country : US
Telephone Number : 248-852-1820
Fax Number :
Provider Business Practice Location Address
First Line : 3916 AUBURN RD STE 100
Second Line :
City : AUBURN HILLS
State : MI
Zip : 48326-3322
Country : US
Telephone Number : 248-852-1820
Fax Number :
Authorized Official
Title or Position : OWNER
Name : GREGORY OKONIEWSKI
Credential : DDS
Telephone Number : 248-852-1820
Provider Enumeration Date : 03/03/2022
Last Update Date : 03/03/2022

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