Provider Demographics
NPI:1689819757
Name:WOSIEK, ZOFIA E (DDS)
Entity Type:Individual
Prefix:MRS
First Name:ZOFIA
Middle Name:E
Last Name:WOSIEK
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 1:6325 W BELMONT AVE
Mailing Address - Street 2:WOSIEK DENTAL INC.
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60634-4025
Mailing Address - Country:US
Mailing Address - Phone:773-237-8999
Mailing Address - Fax:773-237-9033
Practice Address - Street 1:6325 W BELMONT AVE
Practice Address - Street 2:WOSIEK DENTAL INC.
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60634-4025
Practice Address - Country:US
Practice Address - Phone:773-237-8999
Practice Address - Fax:773-237-9033
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-03
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019023070122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist