Provider Demographics
NPI:1093149007
Name:WYRZYKOWSKI, BARBARA EWA (RDH)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:EWA
Last Name:WYRZYKOWSKI
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1051 BEACON ST
Mailing Address - Street 2:SUITE 409
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-5685
Mailing Address - Country:US
Mailing Address - Phone:617-277-0033
Mailing Address - Fax:
Practice Address - Street 1:1051 BEACON ST
Practice Address - Street 2:SUITE 409
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-5685
Practice Address - Country:US
Practice Address - Phone:617-277-0033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-27
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADH88203124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist