MEDICARE: DR. STEVEN A BUDZIK DDS

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	1223G0001X	General Practice Dentistry	7452	IN

General Provider Information

NPI Number	:	1164439592
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN A BUDZIK DDS

Provider Business Mailing Address
First Line	:	6933 KENNEDY AVE
Second Line	:
City	:	HAMMOND
State	:	IN
Zip	:	46323-2210
Country	:	US
Telephone Number	:	219-844-1220
Fax Number	:	219-844-1260

Provider Business Practice Location Address
First Line	:	6933 KENNEDY AVE
Second Line	:
City	:	HAMMOND
State	:	IN
Zip	:	46323-2210
Country	:	US
Telephone Number	:	219-844-1220
Fax Number	:	219-844-1260

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

Provider Enumeration Date	:	08/01/2006
Last Update Date	:	07/08/2007

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