Provider Demographics
NPI:1164649984
Name:CHRZAN, TOMASZ A (DMD)
Entity Type:Individual
Prefix:DR
First Name:TOMASZ
Middle Name:A
Last Name:CHRZAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 SHAKER RD
Mailing Address - Street 2:
Mailing Address - City:EAST LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01028-2731
Mailing Address - Country:US
Mailing Address - Phone:413-525-3000
Mailing Address - Fax:413-525-3004
Practice Address - Street 1:100 SHAKER RD
Practice Address - Street 2:
Practice Address - City:EAST LONGMEADOW
Practice Address - State:MA
Practice Address - Zip Code:01028-2731
Practice Address - Country:US
Practice Address - Phone:413-525-3000
Practice Address - Fax:413-525-3004
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2010-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA215081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice