Provider Demographics
NPI:1386389500
Name:PAUL H. KRZESZOWSKI DDS PLLC
Entity type:Organization
Organization Name:PAUL H. KRZESZOWSKI DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER / OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:KRZESZOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:425-338-2966
Mailing Address - Street 1:15906 MILL CREEK BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98012-1797
Mailing Address - Country:US
Mailing Address - Phone:425-338-2966
Mailing Address - Fax:
Practice Address - Street 1:15906 MILL CREEK BLVD STE 100
Practice Address - Street 2:
Practice Address - City:MILL CREEK
Practice Address - State:WA
Practice Address - Zip Code:98012-1797
Practice Address - Country:US
Practice Address - Phone:425-338-2966
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-02
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental