Provider Demographics
NPI:1497847784
Name:DRS. MICHNICK & TAKACS, D.D.S., PA
Entity type:Organization
Organization Name:DRS. MICHNICK & TAKACS, D.D.S., PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:S
Authorized Official - Last Name:MICHNICK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-213-7575
Mailing Address - Street 1:12308 OCEAN GTWY STE 6
Mailing Address - Street 2:
Mailing Address - City:OCEAN CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21842-9341
Mailing Address - Country:US
Mailing Address - Phone:410-213-7575
Mailing Address - Fax:410-213-2955
Practice Address - Street 1:12308 OCEAN GTWY STE 6
Practice Address - Street 2:
Practice Address - City:OCEAN CITY
Practice Address - State:MD
Practice Address - Zip Code:21842-9341
Practice Address - Country:US
Practice Address - Phone:410-213-7575
Practice Address - Fax:410-213-2955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty