Provider Demographics
NPI:1740295674
Name:WUJICK, CHRIS THOMAS (DMD)
Entity type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:THOMAS
Last Name:WUJICK
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 1:8475 SEMINOLE BLVD
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:FL
Mailing Address - Zip Code:33772-4329
Mailing Address - Country:US
Mailing Address - Phone:727-393-6024
Mailing Address - Fax:727-397-5222
Practice Address - Street 1:8475 SEMINOLE BLVD
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:FL
Practice Address - Zip Code:33772-4329
Practice Address - Country:US
Practice Address - Phone:727-308-6224
Practice Address - Fax:727-397-5222
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-29
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN16886122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist