Provider Demographics
NPI:1174711246
Name:CHRZANOWSKI, M JOSEPH (DDS)
Entity type:Individual
Prefix:DR
First Name:M
Middle Name:JOSEPH
Last Name:CHRZANOWSKI
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 1:782 E 185TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44119-2174
Mailing Address - Country:US
Mailing Address - Phone:216-692-2010
Mailing Address - Fax:216-692-0376
Practice Address - Street 1:782 E 185TH ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44119-2174
Practice Address - Country:US
Practice Address - Phone:216-692-2010
Practice Address - Fax:216-692-0376
Is Sole Proprietor?:No
Enumeration Date:2007-10-14
Last Update Date:2007-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH154081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice