Provider Demographics
NPI:1366678237
Name:CZARNECKI, GAIL ANN (DDS)
Entity Type:Individual
Prefix:DR
First Name:GAIL
Middle Name:ANN
Last Name:CZARNECKI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2775 E GRAND RIVER AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-8532
Mailing Address - Country:US
Mailing Address - Phone:517-518-8620
Mailing Address - Fax:517-798-5675
Practice Address - Street 1:2775 E GRAND RIVER AVE STE 3
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-8532
Practice Address - Country:US
Practice Address - Phone:517-518-8620
Practice Address - Fax:517-798-5675
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-05
Last Update Date:2020-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010196681223G0001X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No1223G0001XDental ProvidersDentistGeneral Practice