Provider Demographics
NPI:1962730929
Name:CHRISTOPHER R DYKI DDS PC
Entity type:Organization
Organization Name:CHRISTOPHER R DYKI DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:DYKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-771-6340
Mailing Address - Street 1:24840 GRATIOT AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:EASTPOINTE
Mailing Address - State:MI
Mailing Address - Zip Code:48021-3381
Mailing Address - Country:US
Mailing Address - Phone:586-771-6340
Mailing Address - Fax:
Practice Address - Street 1:24840 GRATIOT AVE
Practice Address - Street 2:SUITE A
Practice Address - City:EASTPOINTE
Practice Address - State:MI
Practice Address - Zip Code:48021-3381
Practice Address - Country:US
Practice Address - Phone:586-771-6340
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-02
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010184961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty