Healthcare Provider Details

I. General information

NPI: 1902909195
Provider Name (Legal Business Name): CHRISTIAN GERARD ZYLINSKI DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3727 NW 63RD STE 100
OKLAHOMA CITY OK
73116
US

IV. Provider business mailing address

3727 NW 63RD STE 100
OKLAHOMA CITY OK
73116
US

V. Phone/Fax

Practice location:
  • Phone: 405-843-9690
  • Fax: 405-843-9690
Mailing address:
  • Phone: 405-843-9690
  • Fax: 405-843-9691

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number4717
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: