Provider Demographics
NPI:1457929473
Name:FRONCZAK DENTISTRY PLLC
Entity Type:Organization
Organization Name:FRONCZAK DENTISTRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:FRONCZAK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:313-515-0465
Mailing Address - Street 1:48522 VALLEY CT
Mailing Address - Street 2:
Mailing Address - City:PAW PAW
Mailing Address - State:MI
Mailing Address - Zip Code:49079-9300
Mailing Address - Country:US
Mailing Address - Phone:313-515-0465
Mailing Address - Fax:
Practice Address - Street 1:8080 MOORSBRIDGE RD
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49024-4421
Practice Address - Country:US
Practice Address - Phone:313-515-0465
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-15
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty