Provider Demographics
NPI:1043320120
Name:ZYSIK, DAVID ARTHUR (DDS MS)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:ARTHUR
Last Name:ZYSIK
Suffix:
Gender:M
Credentials:DDS MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 EAST ORVIS ST
Mailing Address - Street 2:
Mailing Address - City:MASSENA
Mailing Address - State:NY
Mailing Address - Zip Code:13662-2000
Mailing Address - Country:US
Mailing Address - Phone:315-769-2800
Mailing Address - Fax:
Practice Address - Street 1:55 EAST ORVIS ST
Practice Address - Street 2:
Practice Address - City:MASSENA
Practice Address - State:NY
Practice Address - Zip Code:13662-2000
Practice Address - Country:US
Practice Address - Phone:315-769-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY03882-11223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics