Provider Demographics
NPI:1639259492
Name:VYTYKAC, FRANTISEK (D,DS)
Entity Type:Individual
Prefix:DR
First Name:FRANTISEK
Middle Name:
Last Name:VYTYKAC
Suffix:
Gender:M
Credentials:D,DS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6230 60TH DR
Mailing Address - Street 2:
Mailing Address - City:MASPETH
Mailing Address - State:NY
Mailing Address - Zip Code:11378-3524
Mailing Address - Country:US
Mailing Address - Phone:718-821-2933
Mailing Address - Fax:718-418-6585
Practice Address - Street 1:6230 60TH DR
Practice Address - Street 2:
Practice Address - City:MASPETH
Practice Address - State:NY
Practice Address - Zip Code:11378-3524
Practice Address - Country:US
Practice Address - Phone:718-821-2933
Practice Address - Fax:718-418-6585
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0450631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice