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General NPI Number Information
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NPI Number | 1902674542
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Entity Type | Organization
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Legal Business Name | SERGEI YURYK DDS PA
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Dates
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Enumeration Date | 12/13/2023
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Last Update Date | 12/13/2023
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Provider Practice Location Address
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Address Line | 1000 E HALLANDALE BLVD 1-104
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City | HALLANDALE BEACH
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State | FL
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Zip | 33009
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Country | US
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Telephone | 305-239-9855
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 E HALLANDALE BLVD 1-104
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City | HALLANDALE BEACH
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State | FL
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Zip | 33009
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Country | US
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Telephone | 305-239-9855
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Fax |
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Authorized Official
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Title or Position | DOCTOR/OWNER
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Name | DR. SERGEI YURYK
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Credential | DDS
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Telephone | 847-977-0699
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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