Provider Demographics
NPI:1548236375
Name:WERSCHKY, MARTIN W (DDSPLLC)
Entity Type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:W
Last Name:WERSCHKY
Suffix:
Gender:M
Credentials:DDSPLLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2849 MILLER RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48503-4677
Mailing Address - Country:US
Mailing Address - Phone:810-233-0141
Mailing Address - Fax:810-239-2185
Practice Address - Street 1:2849 MILLER RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503-4677
Practice Address - Country:US
Practice Address - Phone:810-233-0141
Practice Address - Fax:810-239-2185
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI0132111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice