Provider Demographics
NPI:1194550921
Name:SKOWRONSKI, DEANNA M (DMD)
Entity type:Individual
Prefix:DR
First Name:DEANNA
Middle Name:M
Last Name:SKOWRONSKI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37300 SCHOENHERR RD
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48312-2312
Mailing Address - Country:US
Mailing Address - Phone:586-977-8413
Mailing Address - Fax:586-977-8512
Practice Address - Street 1:37300 SCHOENHERR RD
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48312-2312
Practice Address - Country:US
Practice Address - Phone:586-977-8413
Practice Address - Fax:586-977-8512
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-03
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29016020961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice