Provider Demographics
NPI:1114090842
Name:KOWALSKI, WILLIAM J (DMD MS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:J
Last Name:KOWALSKI
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Gender:M
Credentials:DMD MS
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Mailing Address - Street 1:1568 SMIZER STATION ROAD
Mailing Address - Street 2:WILLIAM J KOWALSKI DMD MS
Mailing Address - City:FENTON
Mailing Address - State:MO
Mailing Address - Zip Code:63026
Mailing Address - Country:US
Mailing Address - Phone:636-225-2330
Mailing Address - Fax:636-225-2335
Practice Address - Street 1:1568 SMIZER STATION ROAD
Practice Address - Street 2:WILLIAM J KOWALSKI DMD MS
Practice Address - City:FENTON
Practice Address - State:MO
Practice Address - Zip Code:63026
Practice Address - Country:US
Practice Address - Phone:636-225-2330
Practice Address - Fax:636-225-2335
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MO20010258791223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics