Provider Demographics
NPI:1356577373
Name:PAUL K. PIONTKOWSKI D.D.S. PC
Entity type:Organization
Organization Name:PAUL K. PIONTKOWSKI D.D.S. PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:K
Authorized Official - Last Name:PIONTKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-839-0055
Mailing Address - Street 1:6420 BOCK RD
Mailing Address - Street 2:
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20745-3001
Mailing Address - Country:US
Mailing Address - Phone:301-839-0055
Mailing Address - Fax:301-747-2350
Practice Address - Street 1:6420 BOCK RD
Practice Address - Street 2:
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-3001
Practice Address - Country:US
Practice Address - Phone:301-839-0055
Practice Address - Fax:301-747-2350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-04
Last Update Date:2009-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD93051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD511267Medicare PIN