Individual
LUIZA O WIDAWSKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1349 W MARKET ST, POTTSVILLE, PA 17901-2282
(570) 622-0386
Mailing address
3904 DONNA JANE CT, APT 108A, HARRISBURG, PA 17109-2239
(704) 323-9012
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS035837
PA
Other
Enumeration date
10/26/2006
Last updated
07/08/2007
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