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General NPI Number Information
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NPI Number | 1336980739
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Entity Type | Organization
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Legal Business Name | BYCZEK ORTHODONTICS, INC.
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Dates
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Enumeration Date | 06/03/2024
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 160 S MULBERRY ST
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City | LOGAN
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State | OH
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Zip | 43138-1292
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Country | US
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Telephone | 740-385-8620
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Fax |
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Provider Business Mailing Address
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Address Line | 6890 PERIMETER DR STE B
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City | DUBLIN
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State | OH
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Zip | 43016-8079
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Country | US
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Telephone | 614-332-0277
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | EWA TERESA BYCZEK
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Credential | DDS
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Telephone | 614-718-2222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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