Dennis Lichorwic Dmd PA

NPI #1679990501 in Destin, Florida

Provider Information

NPI Number: 1679990501
Entity Type: Organization
Organization Name: Dennis Lichorwic Dmd PA
Primary Specialty: Dentist
Enumeration Date: Mar 28, 2014
Last Updated: Mar 28, 2014

Practice Location

Address: 4635 GULFSTARR DR
City: Destin
State: Florida
ZIP Code: 32541-5780
Phone: (850) 654-8665

Authorized Official

Name: DR. DENNIS WAYNE LICHORWIC, DMD
Title: OWNER/PRESIDENT
Phone: (850) 654-8665

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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