Provider Demographics
NPI:1043321235
Name:MISLOWSKY, WILLIAM JOHN (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JOHN
Last Name:MISLOWSKY
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 1:1134 YORK ROAD
Mailing Address - Street 2:#209
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-6204
Mailing Address - Country:US
Mailing Address - Phone:410-321-8837
Mailing Address - Fax:410-321-6734
Practice Address - Street 1:1134 YORK ROAD
Practice Address - Street 2:#209
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-6204
Practice Address - Country:US
Practice Address - Phone:410-321-8837
Practice Address - Fax:410-321-6734
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD43521223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
V087Medicare UPIN