Provider Demographics
NPI:1508896887
Name:MICHNIADOWICZ, MAGDALENA A (DDS)
Entity Type:Individual
Prefix:
First Name:MAGDALENA
Middle Name:A
Last Name:MICHNIADOWICZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:MAGDALENA
Other - Middle Name:A
Other - Last Name:SUFIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:206 STONE GATE DR
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130
Mailing Address - Country:US
Mailing Address - Phone:210-694-5056
Mailing Address - Fax:
Practice Address - Street 1:206 STONE GATE DR
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130
Practice Address - Country:US
Practice Address - Phone:830-663-5450
Practice Address - Fax:830-663-9477
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21205122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist