MEDICARE: DR. EDWARD DUSKI JR. DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	2901015317	MI

General Provider Information

NPI Number	:	1033166426
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDWARD DUSKI JR. DDS

Provider Business Mailing Address
First Line	:	911 E M 32
Second Line	:
City	:	GAYLORD
State	:	MI
Zip	:	49735-9701
Country	:	US
Telephone Number	:	989-732-6436
Fax Number	:

Provider Business Practice Location Address
First Line	:	911 E M 32
Second Line	:
City	:	GAYLORD
State	:	MI
Zip	:	49735-9701
Country	:	US
Telephone Number	:	989-732-6436
Fax Number	:	989-705-2656

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/30/2006
Last Update Date	:	07/08/2007

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