Provider Demographics
NPI:1164608287
Name:SZCZESNY, DAVID EDWARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:EDWARD
Last Name:SZCZESNY
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 1:100 W SAGINAW HWY
Mailing Address - Street 2:
Mailing Address - City:GRAND LEDGE
Mailing Address - State:MI
Mailing Address - Zip Code:48837-1800
Mailing Address - Country:US
Mailing Address - Phone:517-627-7000
Mailing Address - Fax:517-627-3785
Practice Address - Street 1:100 W SAGINAW HWY
Practice Address - Street 2:
Practice Address - City:GRAND LEDGE
Practice Address - State:MI
Practice Address - Zip Code:48837-1800
Practice Address - Country:US
Practice Address - Phone:517-627-7000
Practice Address - Fax:517-627-3785
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-18
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010107431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice