Provider Demographics
NPI:1154681211
Name:OKONOWSKI, JOHN FRANCIS (DDS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:FRANCIS
Last Name:OKONOWSKI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31950 23 MILE RD
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48047-4655
Mailing Address - Country:US
Mailing Address - Phone:586-725-6662
Mailing Address - Fax:586-725-6682
Practice Address - Street 1:31950 23 MILE RD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MI
Practice Address - Zip Code:48047-4655
Practice Address - Country:US
Practice Address - Phone:586-725-6662
Practice Address - Fax:586-725-6682
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-23
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010206761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice