Provider Demographics
NPI:1356588750
Name:MOTYKA, JAMIE (DMD)
Entity type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:
Last Name:MOTYKA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:JAMIE
Other - Middle Name:MOTYKA
Other - Last Name:COSTANTINI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:710 KING ST
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06010-4477
Mailing Address - Country:US
Mailing Address - Phone:860-583-8469
Mailing Address - Fax:860-583-8470
Practice Address - Street 1:710 KING ST
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06010-4477
Practice Address - Country:US
Practice Address - Phone:860-583-8469
Practice Address - Fax:860-583-8470
Is Sole Proprietor?:No
Enumeration Date:2009-01-07
Last Update Date:2013-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0083911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice