Provider Demographics
NPI:1023320769
Name:POCZATEK, KAROL MEDINA (DMD)
Entity type:Individual
Prefix:DR
First Name:KAROL
Middle Name:MEDINA
Last Name:POCZATEK
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5751 POCAHONTAS RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:BESSEMER
Mailing Address - State:AL
Mailing Address - Zip Code:35022-5345
Mailing Address - Country:US
Mailing Address - Phone:205-477-4242
Mailing Address - Fax:205-477-4243
Practice Address - Street 1:2685 PELHAM PKWY
Practice Address - Street 2:SUITE B
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35214
Practice Address - Country:US
Practice Address - Phone:205-216-0522
Practice Address - Fax:205-216-0520
Is Sole Proprietor?:No
Enumeration Date:2010-07-10
Last Update Date:2012-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALLNO57721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice