MEDICARE: DR. JOSEPH MARTIN TALCIK D.M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	027915	NY

General Provider Information

NPI Number	:	1770675753
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH MARTIN TALCIK D.M.D

Provider Business Mailing Address
First Line	:	5303 AQUARIUS DR
Second Line	:
City	:	SYRACUSE
State	:	NY
Zip	:	13224-2147
Country	:	US
Telephone Number	:	315-445-1594
Fax Number	:

Provider Business Practice Location Address
First Line	:	4933 JAMESVILLE RD
Second Line	:
City	:	JAMESVILLE
State	:	NY
Zip	:	13078-9428
Country	:	US
Telephone Number	:	315-446-6620
Fax Number	:	315-446-6621

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/28/2006
Last Update Date	:	07/08/2007

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