Provider Demographics
NPI:1295316545
Name:BYCZEK ORTHODONTICS, INC.
Entity type:Organization
Organization Name:BYCZEK ORTHODONTICS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EWA
Authorized Official - Middle Name:TERESA
Authorized Official - Last Name:BYCZEK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:740-594-5400
Mailing Address - Street 1:4748 DONEGAL CLIFFS DR
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-8659
Mailing Address - Country:US
Mailing Address - Phone:614-332-0277
Mailing Address - Fax:614-547-6532
Practice Address - Street 1:211 COLUMBUS RD
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:OH
Practice Address - Zip Code:45701-1335
Practice Address - Country:US
Practice Address - Phone:740-594-5400
Practice Address - Fax:614-547-6532
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BYCZEK ORTHODONTICS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-04-19
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty