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NPI Code Detail

MEDICARE: DR. PAUL A PLADZIEWICZ DDS

MEDICARE: DR. PAUL A PLADZIEWICZ 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
1122300000XDentistIL

General Provider Information

NPI Number : 1235120205
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PAUL A PLADZIEWICZ DDS
Provider Business Mailing Address
First Line : 6300 W TOUHY AVE
Second Line : #426
City : NILES
State : IL
Zip : 60714-4627
Country : US
Telephone Number : 773-457-6029
Fax Number :
Provider Business Practice Location Address
First Line : 3153 W FULLERTON AVE
Second Line : FULLERTON/KEDZIE DENTAL GROUP
City : CHICAGO
State : IL
Zip : 60647-2809
Country : US
Telephone Number : 773-278-6604
Fax Number : 773-395-4633
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2005
Last Update Date : 07/08/2007

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