Provider Demographics
NPI:1083863237
Name:MUZYKA, BRIAN C (DMD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:C
Last Name:MUZYKA
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 1:600 MOYE BLVD
Mailing Address - Street 2:HOSPITAL DENTISTRY ECU SCHOOL OF DENTAL MEDICINE
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-4300
Mailing Address - Country:US
Mailing Address - Phone:252-744-4618
Mailing Address - Fax:252-744-2827
Practice Address - Street 1:600 MOYE BLVD
Practice Address - Street 2:ECU PHYSICIANS FAMILY PRACTICE DENTAL CENTER
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-4300
Practice Address - Country:US
Practice Address - Phone:252-744-4618
Practice Address - Fax:252-744-2056
Is Sole Proprietor?:No
Enumeration Date:2008-09-11
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3000691223G0001X
PADS027508L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5911442Medicaid
NC2073743Medicare PIN
NC2073743AMedicare PIN