Provider Demographics
NPI:1689753451
Name:WOZNICKI, GARY EUGENE (DDS)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:EUGENE
Last Name:WOZNICKI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26300 EUCLID AVE
Mailing Address - Street 2:SUITE 424
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44132-3708
Mailing Address - Country:US
Mailing Address - Phone:216-731-7555
Mailing Address - Fax:216-731-5503
Practice Address - Street 1:26300 EUCLID AVE
Practice Address - Street 2:SUITE 424
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44132-3708
Practice Address - Country:US
Practice Address - Phone:216-731-7555
Practice Address - Fax:216-731-5503
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH162931223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics