Provider Demographics
NPI:1063279024
Name:CARL S. PIONTKOWSKI DDS FAMILY & COSMETIC DENTISTRY PC
Entity type:Organization
Organization Name:CARL S. PIONTKOWSKI DDS FAMILY & COSMETIC DENTISTRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARL
Authorized Official - Middle Name:
Authorized Official - Last Name:PIONTKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:586-263-5540
Mailing Address - Street 1:42657 GARFIELD RD STE GARFIELD
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-5023
Mailing Address - Country:US
Mailing Address - Phone:586-263-5540
Mailing Address - Fax:
Practice Address - Street 1:42657 GARFIELD RD STE GARFIELD
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-5023
Practice Address - Country:US
Practice Address - Phone:586-263-5540
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-05
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty