Provider Demographics
NPI:1194944884
Name:WOZNIAK, DAVID STANLEY (ENDODONTIST DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:STANLEY
Last Name:WOZNIAK
Suffix:
Gender:M
Credentials:ENDODONTIST DDS
Other - Prefix:
Other - First Name:DAVID
Other - Middle Name:S
Other - Last Name:WOZNIAK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS MS
Mailing Address - Street 1:1612 HUGUENOT RD
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113
Mailing Address - Country:US
Mailing Address - Phone:804-794-9789
Mailing Address - Fax:804-419-1059
Practice Address - Street 1:12040 W. BROAD STREET
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23233
Practice Address - Country:US
Practice Address - Phone:804-364-7010
Practice Address - Fax:804-419-1059
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010056651223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics