Provider Demographics
NPI:1033166426
Name:DUSKI, EDWARD JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:
Last Name:DUSKI
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:EDWARD
Other - Middle Name:
Other - Last Name:DUSKI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:911 E M 32
Mailing Address - Street 2:
Mailing Address - City:GAYLORD
Mailing Address - State:MI
Mailing Address - Zip Code:49735-9701
Mailing Address - Country:US
Mailing Address - Phone:989-732-6436
Mailing Address - Fax:
Practice Address - Street 1:911 E M 32
Practice Address - Street 2:
Practice Address - City:GAYLORD
Practice Address - State:MI
Practice Address - Zip Code:49735-9701
Practice Address - Country:US
Practice Address - Phone:989-732-6436
Practice Address - Fax:989-705-2656
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010153171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice