Provider Demographics
NPI:1215667449
Name:CZARNECKI, AUSTIN (DDS)
Entity type:Individual
Prefix:
First Name:AUSTIN
Middle Name:
Last Name:CZARNECKI
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 1:61 W MUNDHANK RD
Mailing Address - Street 2:
Mailing Address - City:S BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-9317
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2641 8TH AVE S
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204-2483
Practice Address - Country:US
Practice Address - Phone:615-784-5104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-11
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11981122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist