Provider Demographics
NPI:1649493040
Name:GRZYBICKI, SANDRA EMILIE (DMD)
Entity type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:EMILIE
Last Name:GRZYBICKI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:101 E LANCASTER AVE
Mailing Address - Street 2:
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301-1421
Mailing Address - Country:US
Mailing Address - Phone:610-647-6688
Mailing Address - Fax:610-725-9243
Practice Address - Street 1:101 E LANCASTER AVE
Practice Address - Street 2:
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301
Practice Address - Country:US
Practice Address - Phone:610-647-6688
Practice Address - Fax:610-725-9243
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22D1020931001223P0221X
PADS0304521223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry