Provider Demographics
NPI:1174534986
Name:KADZIK, PAUL L (DDS)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:L
Last Name:KADZIK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3518 HARBORVIEW DR
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98332-2128
Mailing Address - Country:US
Mailing Address - Phone:253-851-6579
Mailing Address - Fax:
Practice Address - Street 1:14315 62ND AVE NW
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98332-8664
Practice Address - Country:US
Practice Address - Phone:253-851-4025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA5272122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist