Provider Demographics
NPI:1861633141
Name:PLASCYK, PAUL S (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:S
Last Name:PLASCYK
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 1:10815 SIKES PLACE
Mailing Address - Street 2:SUITE 310
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277
Mailing Address - Country:US
Mailing Address - Phone:704-841-7358
Mailing Address - Fax:704-841-0730
Practice Address - Street 1:10815 SIKES PLACE
Practice Address - Street 2:SUITE 310
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277
Practice Address - Country:US
Practice Address - Phone:704-841-7358
Practice Address - Fax:704-841-0730
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-16
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7351122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist