Organization
J. MICHAEL PANCZYSZYN, D.D.S., PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
J. MICHAEL PANCZYSZYN D.D.S. (DENTIST)
(386) 756-3728
Entity
Organization
Contact information
Practice address
938 BRIDGEWATER DR, UNIT 3B, PORT ORANGE, FL 32129-6108
(386) 756-3728
Mailing address
938 BRIDGEWATER DR, UNIT 3B, PORT ORANGE, FL 32129-6108
(386) 756-3728
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DN0009950
FL
Other
Enumeration date
04/15/2008
Last updated
04/15/2008
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