Provider Demographics
NPI:1043376072
Name:DYREK, WOJCIECH (DDS)
Entity Type:Individual
Prefix:MR
First Name:WOJCIECH
Middle Name:
Last Name:DYREK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2604 E DEMPSTER
Mailing Address - Street 2:SUITE 309 B
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068
Mailing Address - Country:US
Mailing Address - Phone:847-827-6200
Mailing Address - Fax:847-827-6209
Practice Address - Street 1:2604 E DEMPSTER
Practice Address - Street 2:SUITE 309 B
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068
Practice Address - Country:US
Practice Address - Phone:847-827-6200
Practice Address - Fax:847-827-6209
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist