Provider Demographics
NPI:1265456859
Name:DENNIS C. OWOCKI DDS,PC
Entity Type:Organization
Organization Name:DENNIS C. OWOCKI DDS,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:C
Authorized Official - Last Name:OWOCKI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:810-629-2121
Mailing Address - Street 1:219 W ROBERTS ST
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48430-2634
Mailing Address - Country:US
Mailing Address - Phone:810-629-2121
Mailing Address - Fax:810-629-8942
Practice Address - Street 1:219 W ROBERTS ST
Practice Address - Street 2:
Practice Address - City:FENTON
Practice Address - State:MI
Practice Address - Zip Code:48430-2634
Practice Address - Country:US
Practice Address - Phone:810-629-2121
Practice Address - Fax:810-629-8942
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010081171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty