Provider Demographics
NPI:1881711513
Name:DROZDOWICZ, MARTIN ALLEN (DDS)
Entity type:Individual
Prefix:DR
First Name:MARTIN
Middle Name:ALLEN
Last Name:DROZDOWICZ
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 1:5323 RAVEN PKWY
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48161-3716
Mailing Address - Country:US
Mailing Address - Phone:734-243-6282
Mailing Address - Fax:
Practice Address - Street 1:5323 RAVEN PKWY
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48161-3716
Practice Address - Country:US
Practice Address - Phone:734-243-6282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI106571223G0001X
OH300144281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice