Provider Demographics
NPI:1750385472
Name:GAWRONSKI, DENNIS E (RPH)
Entity type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:E
Last Name:GAWRONSKI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:MR
Other - First Name:DENNIS
Other - Middle Name:E
Other - Last Name:GAWRONSKI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMACIST
Mailing Address - Street 1:4636 KY ROUTE 114
Mailing Address - Street 2:
Mailing Address - City:PRESTONSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41653-9085
Mailing Address - Country:US
Mailing Address - Phone:606-886-0249
Mailing Address - Fax:606-886-0249
Practice Address - Street 1:308 S MAYO TRL
Practice Address - Street 2:
Practice Address - City:PAINTSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41240-1247
Practice Address - Country:US
Practice Address - Phone:606-789-4950
Practice Address - Fax:606-789-7354
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY9983183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist