Provider Demographics
NPI:1053839043
Name:STYRBICKI, ALEX MICHAEL (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALEX
Middle Name:MICHAEL
Last Name:STYRBICKI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8066 BROOKLYN BLVD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55445-2407
Mailing Address - Country:US
Mailing Address - Phone:763-315-1875
Mailing Address - Fax:763-391-7629
Practice Address - Street 1:8066 BROOKLYN BLVD
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55445-2407
Practice Address - Country:US
Practice Address - Phone:763-315-1875
Practice Address - Fax:763-391-7629
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-30
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND13917122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist