Provider Demographics
NPI:1861402356
Name:WOJCIK, MICHAEL S (DDS,MS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:S
Last Name:WOJCIK
Suffix:
Gender:M
Credentials:DDS,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8130 CONSTITUTION BLVD
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48313-3801
Mailing Address - Country:US
Mailing Address - Phone:586-268-5520
Mailing Address - Fax:586-268-1288
Practice Address - Street 1:8130 CONSTITUTION BLVD
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48313-3801
Practice Address - Country:US
Practice Address - Phone:586-268-5520
Practice Address - Fax:586-268-1288
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010150791223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics