Provider Demographics
NPI:1568745602
Name:VIECHNICKI, BRYON JOSEPH (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:BRYON
Middle Name:JOSEPH
Last Name:VIECHNICKI
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:346 GEORGES RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08810-1509
Mailing Address - Country:US
Mailing Address - Phone:732-274-2211
Mailing Address - Fax:
Practice Address - Street 1:122 E BROAD ST
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-6276
Practice Address - Country:US
Practice Address - Phone:610-865-4333
Practice Address - Fax:610-882-0297
Is Sole Proprietor?:No
Enumeration Date:2011-09-26
Last Update Date:2017-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI025585001223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics