Provider Demographics
NPI:1255461406
Name:CYRIAC, BIJU (DDS)
Entity type:Individual
Prefix:DR
First Name:BIJU
Middle Name:
Last Name:CYRIAC
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2813 CANDLELIGHT DR
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-8802
Mailing Address - Country:US
Mailing Address - Phone:717-683-6717
Mailing Address - Fax:443-394-3450
Practice Address - Street 1:9419 COMMON BROOK RD
Practice Address - Street 2:SUITE 210
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-7536
Practice Address - Country:US
Practice Address - Phone:443-394-2273
Practice Address - Fax:443-394-3450
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD128581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice