Provider Demographics
NPI:1538231543
Name:WILCZANSKI, HALINA B (DMD)
Entity type:Individual
Prefix:DR
First Name:HALINA
Middle Name:B
Last Name:WILCZANSKI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5241 BUFFALO RD
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16510
Mailing Address - Country:US
Mailing Address - Phone:814-898-2401
Mailing Address - Fax:814-877-7692
Practice Address - Street 1:5241 BUFFALO RD
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16510
Practice Address - Country:US
Practice Address - Phone:814-898-2401
Practice Address - Fax:814-877-7692
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS026583L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist