Provider Demographics
NPI:1528411832
Name:WOJCIK, ABBY
Entity Type:Individual
Prefix:
First Name:ABBY
Middle Name:
Last Name:WOJCIK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 S CHERRY WAY
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-6714
Mailing Address - Country:US
Mailing Address - Phone:586-883-2899
Mailing Address - Fax:
Practice Address - Street 1:2801 S CHERRY WAY
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-6714
Practice Address - Country:US
Practice Address - Phone:586-883-2899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-21
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO906171124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist