Provider Demographics
NPI:1396875027
Name:LEWCZUK, WILLIAM (DDS)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:LEWCZUK
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 1:5906 MONTEREY RD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90042-4943
Mailing Address - Country:US
Mailing Address - Phone:323-256-2680
Mailing Address - Fax:323-341-5668
Practice Address - Street 1:5906 MONTEREY RD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90042-4943
Practice Address - Country:US
Practice Address - Phone:323-256-2680
Practice Address - Fax:323-341-5668
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38869122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist