Provider Demographics
NPI:1235120205
Name:PLADZIEWICZ, PAUL A (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:A
Last Name:PLADZIEWICZ
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 1:6300 W TOUHY AVE
Mailing Address - Street 2:#426
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-4627
Mailing Address - Country:US
Mailing Address - Phone:773-457-6029
Mailing Address - Fax:
Practice Address - Street 1:3153 W FULLERTON AVE
Practice Address - Street 2:FULLERTON/KEDZIE DENTAL GROUP
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-2809
Practice Address - Country:US
Practice Address - Phone:773-278-6604
Practice Address - Fax:773-395-4633
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist