Provider Demographics
NPI:1316046071
Name:RONALD J GRYCKO DDS INC
Entity Type:Organization
Organization Name:RONALD J GRYCKO DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:GRYCKO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:513-791-3138
Mailing Address - Street 1:9050 PLAINFIELD ROAD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-1200
Mailing Address - Country:US
Mailing Address - Phone:513-791-3138
Mailing Address - Fax:513-791-3139
Practice Address - Street 1:9050 PLAINFIELD ROAD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236-1200
Practice Address - Country:US
Practice Address - Phone:513-791-3138
Practice Address - Fax:513-791-3139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300186181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty