Provider Demographics
NPI:1023118973
Name:KWARCIANY, DONALD ALLEN (DDS MS)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:ALLEN
Last Name:KWARCIANY
Suffix:
Gender:M
Credentials:DDS MS
Other - Prefix:DR
Other - First Name:DONALD
Other - Middle Name:ALLEN
Other - Last Name:KWARCIANY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS MS
Mailing Address - Street 1:11035 W FOREST HOME AVE
Mailing Address - Street 2:116
Mailing Address - City:HALES CORNERS
Mailing Address - State:WI
Mailing Address - Zip Code:53130
Mailing Address - Country:US
Mailing Address - Phone:414-529-1110
Mailing Address - Fax:414-529-1134
Practice Address - Street 1:11035 W FOREST HOME AVE
Practice Address - Street 2:116
Practice Address - City:HALES CORNERS
Practice Address - State:WI
Practice Address - Zip Code:53130
Practice Address - Country:US
Practice Address - Phone:414-529-1110
Practice Address - Fax:414-529-1134
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI48830151223P0221X
MI29010148071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No1223P0221XDental ProvidersDentistPediatric Dentistry