Marc John Czarnowski, D.M.D.
Individual provider Active NPI General Practice Dentistry · Mansfield Center, CT
NPI 1275650699 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1275650699
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 6192 (CT)
- Practice address
- 10 Higgins Hwy
Suite 1
Mansfield Center, CT 06250-1437 - Phone
- (860) 456-2906
- NPI assigned
- Mar 22, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150609000546 | CT | Order and Referring Only - Oral Surgery |
6204157720 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6192 | CT | MD | Dental Hygienist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mansfield CT Dental PLLC | Past |
Accepting new patients | |
| Mansfield Family Dental | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 6192 | CT | Yes |
Addresses
Primary practice location
10 Higgins Hwy
Suite 1
Mansfield Center, CT 06250-1437
Mailing address
10 Higgins Hwy
Suite 1
Mansfield Center, CT 06250-1437
Phone (860) 456-2906
Other providers in Mansfield Center, CT
- Cranmer Eye Center, P.C.
- Creative Change Counseling LLC
- Mary Ann Crespo
- Dean G Cruess
- Annelyse Cyr
- Kate D'Addabbo
- Fabiana Aretusa Da Silva
- Karen Ann Daly
- Danielle N. Christian, LCSW, LLC
- Kristy Victoria Davenport
All providers in Mansfield Center, CT · General Practice Dentistry in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.