Provider Demographics
NPI:1518122795
Name:DUSZYNSKI, ADRIAN DRAKE (DDS)
Entity Type:Individual
Prefix:DR
First Name:ADRIAN
Middle Name:DRAKE
Last Name:DUSZYNSKI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6510 GRAND TETON PLZ
Mailing Address - Street 2:412
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719-1029
Mailing Address - Country:US
Mailing Address - Phone:608-833-0305
Mailing Address - Fax:608-833-1121
Practice Address - Street 1:6510 GRAND TETON PLZ
Practice Address - Street 2:412
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-1029
Practice Address - Country:US
Practice Address - Phone:608-833-0305
Practice Address - Fax:608-833-1121
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-27
Last Update Date:2008-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5000407-015122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice