Provider Demographics
NPI:1114090362
Name:YURYK, SERGEI (DDS)
Entity Type:Individual
Prefix:DR
First Name:SERGEI
Middle Name:
Last Name:YURYK
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 1:1000 E HALLANDALE BEACH BLVD # 1-104
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-4433
Mailing Address - Country:US
Mailing Address - Phone:847-977-0699
Mailing Address - Fax:
Practice Address - Street 1:1000 E HALLANDALE BEACH BLVD # 1-104
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-4433
Practice Address - Country:US
Practice Address - Phone:847-977-0699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN263441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice