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General NPI Number Information
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NPI Number | 1891112207
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Entity Type | Organization
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Legal Business Name | LYNNE G. HALIK DDS
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Dates
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Enumeration Date | 03/24/2014
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Last Update Date | 05/26/2021
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Provider Practice Location Address
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Address Line | 145 SULLYS TRL
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City | PITTSFORD
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State | NY
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Zip | 14534-4561
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Country | US
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Telephone | 585-381-2190
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Fax |
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Provider Business Mailing Address
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Address Line | 145 SULLYS TRL
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City | PITTSFORD
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State | NY
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Zip | 14534-4561
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Country | US
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Telephone | 585-381-2190
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Fax |
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | MRS. SHERRIE IVY
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Credential |
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Telephone | 585-381-2190
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 0366441
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License Number State | NY
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