Provider Demographics
NPI:1417573296
Name:WOYTYCH, ALLISON E (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:E
Last Name:WOYTYCH
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:E
Other - Last Name:STEPHANS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:472 BOND DR
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:IL
Mailing Address - Zip Code:60510-8685
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:625 WALNUT RIDGE DR STE 102
Practice Address - Street 2:
Practice Address - City:HARTLAND
Practice Address - State:WI
Practice Address - Zip Code:53029-8803
Practice Address - Country:US
Practice Address - Phone:262-367-4255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-17
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1002309-15122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist