Individual
DR. HANS WERNER WAWROUSEK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
122 PINE DR, BLACK RIVER, NY 13612-2110
(315) 773-0573
Mailing address
122 PINE DR, BLACK RIVER, NY 13612-2110
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
031625
NY
Other
Enumeration date
10/20/2005
Last updated
06/30/2014
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