Provider Demographics
NPI:1184237034
Name:OWCZARUK, STEVEN M (DMD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:M
Last Name:OWCZARUK
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 1:4839 CAL SAG RD # 310
Mailing Address - Street 2:
Mailing Address - City:CRESTWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60418-4415
Mailing Address - Country:US
Mailing Address - Phone:708-689-5273
Mailing Address - Fax:
Practice Address - Street 1:4839 CAL SAG RD # 310
Practice Address - Street 2:
Practice Address - City:CRESTWOOD
Practice Address - State:IL
Practice Address - Zip Code:60418-4415
Practice Address - Country:US
Practice Address - Phone:708-689-5273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-28
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.032660122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist