Provider Demographics
NPI:1447239827
Name:POLANSKY, HOWARD (DMD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:
Last Name:POLANSKY
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 1:1616 FM 685
Mailing Address - Street 2:STE # 103
Mailing Address - City:PFLUGERVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78660-7536
Mailing Address - Country:US
Mailing Address - Phone:512-252-4655
Mailing Address - Fax:512-252-4657
Practice Address - Street 1:1616 FM 685
Practice Address - Street 2:STE # 103
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-7536
Practice Address - Country:US
Practice Address - Phone:512-252-4655
Practice Address - Fax:512-252-4657
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-12
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0355341223G0001X
TX226521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice