Individual
DR. NIKOLAS MARK WASYLYK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
550 UNIVERSITY BLVD # UH3145, INDIANAPOLIS, IN 46202-5149
(215) 955-6215
(215) 923-9189
Mailing address
715 SANSOM ST APT 4F, PHILADELPHIA, PA 19106-3320
(484) 763-0747
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DS043424
PA
Other
Enumeration date
11/01/2021
Last updated
07/26/2022
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