# PHILLIP A WIENCZEWSKI PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790963312
- **Authorized official:** DR. PHILLIP ALLEN WIENCZEWSKI DDS (OWNER)
- **Authorized official phone:** (989) 984-0560

## Contact information

- **Practice address:** 671 E M 55, TAWAS CITY, MI 48763
- **Practice address phone:** (989) 984-0560
- **Practice address fax:** (989) 984-0562
- **Mailing address:** 671 E M 55, TAWAS CITY, MI 48763
- **Mailing address phone:** (989) 984-0560
- **Mailing address fax:** (989) 984-0562

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 9807 | MI | Yes |

## Other

- **Enumeration date:** 02/06/2008
- **Last updated:** 02/06/2008