Provider Demographics
NPI:1346364460
Name:CZARZASTY, PAUL FRANCIS (DMD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:FRANCIS
Last Name:CZARZASTY
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:PO BOX 4674
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06704-0674
Mailing Address - Country:US
Mailing Address - Phone:203-753-8081
Mailing Address - Fax:203-753-8081
Practice Address - Street 1:934 CHASE PKWY
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-2916
Practice Address - Country:US
Practice Address - Phone:203-753-8081
Practice Address - Fax:203-753-8081
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT47601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice