Provider Demographics
NPI:1699050724
Name:SZYMANOWSKI, CASIMIR THADDEUS (DDS)
Entity type:Individual
Prefix:DR
First Name:CASIMIR
Middle Name:THADDEUS
Last Name:SZYMANOWSKI
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 1:99 SCRIPPS DR
Mailing Address - Street 2:200
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-6317
Mailing Address - Country:US
Mailing Address - Phone:916-929-5050
Mailing Address - Fax:916-929-5416
Practice Address - Street 1:99 SCRIPPS DR
Practice Address - Street 2:200
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-6317
Practice Address - Country:US
Practice Address - Phone:916-929-5050
Practice Address - Fax:916-929-5416
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-20
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19011122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist