Provider Demographics
NPI:1124176599
Name:MUZYCHKA, CHRISTINE RENE (DDS)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:RENE
Last Name:MUZYCHKA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4053 S. LAPEER RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:METAMORA
Mailing Address - State:MI
Mailing Address - Zip Code:48455
Mailing Address - Country:US
Mailing Address - Phone:810-678-2244
Mailing Address - Fax:810-678-3668
Practice Address - Street 1:4053 S.LAPEER RD
Practice Address - Street 2:SUITE B
Practice Address - City:METAMORA
Practice Address - State:MI
Practice Address - Zip Code:48455
Practice Address - Country:US
Practice Address - Phone:810-678-2244
Practice Address - Fax:810-678-3668
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI17456122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist