MEDICARE: DR. CLAUDIA PRYSZLAK D.M.D

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	DN14774	FL

General Provider Information

NPI Number	:	1730347857
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CLAUDIA PRYSZLAK D.M.D

Provider Business Mailing Address
First Line	:	7332 OFFICE PARK PL
Second Line	:	SUITE 102
City	:	VIERA
State	:	FL
Zip	:	32940-8241
Country	:	US
Telephone Number	:	321-255-7740
Fax Number	:	321-255-7533

Provider Business Practice Location Address
First Line	:	7332 OFFICE PARK PL
Second Line	:	SUITE 102
City	:	VIERA
State	:	FL
Zip	:	32940-8241
Country	:	US
Telephone Number	:	321-255-7740
Fax Number	:	321-255-7533

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

Provider Enumeration Date	:	05/27/2008
Last Update Date	:	05/27/2008

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