MEDICARE: DR. CHRISTOPHER KRZYSZTOF KROWICKI D.D.S.

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
1	122300000X	Dentist	DS036946	PA

General Provider Information

NPI Number	:	1043308646
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER KRZYSZTOF KROWICKI D.D.S.

Provider Business Mailing Address
First Line	:	1262 CEDAR TOP RD
Second Line	:
City	:	SHILLINGTON
State	:	PA
Zip	:	19607-9327
Country	:	US
Telephone Number	:	610-750-4033
Fax Number	:

Provider Business Practice Location Address
First Line	:	240 S 40TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-6030
Country	:	US
Telephone Number	:	215-898-4615
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/10/2006
Last Update Date	:	04/25/2022

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