Provider Demographics
NPI:1952322752
Name:HENRY S. BYLICKY,JR.,D.D.S.,P.C.
Entity Type:Organization
Organization Name:HENRY S. BYLICKY,JR.,D.D.S.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:STANLEY
Authorized Official - Last Name:BYLICKY
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:845-727-4122
Mailing Address - Street 1:77 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10960-3109
Mailing Address - Country:US
Mailing Address - Phone:845-727-4122
Mailing Address - Fax:845-358-2465
Practice Address - Street 1:77 MAIN ST
Practice Address - Street 2:
Practice Address - City:NYACK
Practice Address - State:NY
Practice Address - Zip Code:10960-3109
Practice Address - Country:US
Practice Address - Phone:845-727-4122
Practice Address - Fax:845-358-2465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2011-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty