Provider Demographics
NPI:1588223895
Name:BOZYK, WHITNEY MARIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:WHITNEY
Middle Name:MARIE
Last Name:BOZYK
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7051 MARSH RIDGE TRL
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:MI
Mailing Address - Zip Code:49012-9403
Mailing Address - Country:US
Mailing Address - Phone:248-420-8125
Mailing Address - Fax:
Practice Address - Street 1:5475 BECKLEY RD
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-4109
Practice Address - Country:US
Practice Address - Phone:269-979-7710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-10
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010232171223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice