Provider Demographics
NPI:1972682599
Name:WOJTKOWSKI, ANDREW MICHAEL (DMD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:MICHAEL
Last Name:WOJTKOWSKI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 MERCY DR NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44708-2614
Mailing Address - Country:US
Mailing Address - Phone:330-489-1111
Mailing Address - Fax:330-489-1281
Practice Address - Street 1:3768 BOARDMAN CANFIELD RD
Practice Address - Street 2:
Practice Address - City:CANFIELD
Practice Address - State:OH
Practice Address - Zip Code:44406
Practice Address - Country:US
Practice Address - Phone:330-702-1288
Practice Address - Fax:330-702-1291
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2018-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH 158731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice