Provider Demographics
NPI:1598898041
Name:KUSZ, KATARZYNA DOROTA (DDS)
Entity Type:Individual
Prefix:DR
First Name:KATARZYNA
Middle Name:DOROTA
Last Name:KUSZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6075 N NORTHWEST HWY
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60631-2502
Mailing Address - Country:US
Mailing Address - Phone:773-792-8008
Mailing Address - Fax:773-792-2908
Practice Address - Street 1:6075 N NORTHWEST HWY
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60631-2502
Practice Address - Country:US
Practice Address - Phone:773-792-8008
Practice Address - Fax:773-792-2908
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice