Provider Demographics
NPI:1669097481
Name:SZYMANSKI, JOSEPH ANTONIO (DDS)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:ANTONIO
Last Name:SZYMANSKI
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 1:54459 MAPLE CREEK CT
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48316-6014
Mailing Address - Country:US
Mailing Address - Phone:586-201-7599
Mailing Address - Fax:
Practice Address - Street 1:3782 S LAPEER RD STE 100
Practice Address - Street 2:
Practice Address - City:METAMORA
Practice Address - State:MI
Practice Address - Zip Code:48455-8753
Practice Address - Country:US
Practice Address - Phone:810-678-2224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-09
Last Update Date:2020-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29016005121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice