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NPI Code Detail

MEDICARE: TIMOTHY OWCZARZAK DMD, PC

MEDICARE: TIMOTHY OWCZARZAK DMD, PC
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
11223G0001XGeneral Practice DentistryDS0279955LPA

General Provider Information

NPI Number : 1154581866
Entity Type Code : Organization
Provider Name (Legal Business Name) : TIMOTHY OWCZARZAK DMD, PC
Provider Business Mailing Address
First Line : PO BOX 3189
Second Line :
City : SYRACUSE
State : NY
Zip : 13220-3189
Country : US
Telephone Number : 315-454-6000
Fax Number :
Provider Business Practice Location Address
First Line : 7372 MCKNIGHT RD # B
Second Line :
City : PITTSBURGH
State : PA
Zip : 15237-3558
Country : US
Telephone Number : 412-364-6440
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. TIMOTHY OWCZARZAK
Credential : DMD
Telephone Number : 412-364-6440
Provider Enumeration Date : 06/16/2008
Last Update Date : 06/16/2008

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