Provider Demographics
NPI:1962957951
Name:MOTSYUK, YURIY (DMD)
Entity type:Individual
Prefix:
First Name:YURIY
Middle Name:
Last Name:MOTSYUK
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2140 VOORHEES TOWN CTR
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-1911
Mailing Address - Country:US
Mailing Address - Phone:856-770-1770
Mailing Address - Fax:856-770-1779
Practice Address - Street 1:2140 VOORHEES TOWN CTR
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-1911
Practice Address - Country:US
Practice Address - Phone:856-770-1770
Practice Address - Fax:856-770-1779
Is Sole Proprietor?:No
Enumeration Date:2016-08-18
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI026399001223G0001X
PADS0409141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice