Provider Demographics
NPI:1902674542
Name:SERGEI YURYK DDS PA
Entity type:Organization
Organization Name:SERGEI YURYK DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SERGEI
Authorized Official - Middle Name:
Authorized Official - Last Name:YURYK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:847-977-0699
Mailing Address - Street 1:1000 E HALLANDALE BLVD
Mailing Address - Street 2:1-104
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009
Mailing Address - Country:US
Mailing Address - Phone:305-239-9855
Mailing Address - Fax:
Practice Address - Street 1:1000 E HALLANDALE BLVD
Practice Address - Street 2:1-104
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009
Practice Address - Country:US
Practice Address - Phone:305-239-9855
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-13
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental