Organization
DENNIS LICHORWIC DMD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DENNIS WAYNE LICHORWIC DMD (OWNER/PRESIDENT)
(850) 654-8665
Entity
Organization
Contact information
Practice address
4635 GULFSTARR DR, DESTIN, FL 32541-5780
(850) 654-8665
(850) 654-9584
Mailing address
4635 GULFSTARR DR, DESTIN, FL 32541-5780
(850) 654-8665
(850) 654-9584
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0014608
FL
122300000X
Dentist
DN19333
FL
122300000X
Dentist
DN19829
FL
Other
Enumeration date
03/28/2014
Last updated
03/28/2014
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