Provider Demographics
NPI:1588155337
Name:WYTKO, MARIA CHRISTINE (DMD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:CHRISTINE
Last Name:WYTKO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8203 W ORAIBI DR APT 2093
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85382-6600
Mailing Address - Country:US
Mailing Address - Phone:509-969-0889
Mailing Address - Fax:
Practice Address - Street 1:267 E BELL RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85022-6337
Practice Address - Country:US
Practice Address - Phone:602-993-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-28
Last Update Date:2018-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD0099981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice