Provider Demographics
NPI:1184731093
Name:DUSKIN, BRYCE KELLY (D,D,S)
Entity type:Individual
Prefix:DR
First Name:BRYCE
Middle Name:KELLY
Last Name:DUSKIN
Suffix:
Gender:M
Credentials:D,D,S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20302 77TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223-7462
Mailing Address - Country:US
Mailing Address - Phone:360-435-2151
Mailing Address - Fax:
Practice Address - Street 1:20302 77TH AVE NE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-7462
Practice Address - Country:US
Practice Address - Phone:360-435-2151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDD37461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice