MEDICARE: BRYCE K DUSKIN DDS PS

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	DE60099566	WA

General Provider Information

NPI Number	:	1083926778
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRYCE K DUSKIN DDS PS

Provider Business Mailing Address
First Line	:	20210 77TH AVE NE
Second Line	:
City	:	ARLINGTON
State	:	WA
Zip	:	98223-4602
Country	:	US
Telephone Number	:	360-435-2151
Fax Number	:	360-435-7845

Provider Business Practice Location Address
First Line	:	20210 77TH AVE NE
Second Line	:
City	:	ARLINGTON
State	:	WA
Zip	:	98223-4602
Country	:	US
Telephone Number	:	360-435-2151
Fax Number	:	360-435-7845

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. BRYCE K DUSKIN
Credential	:	DDS
Telephone Number	:	360-435-2151

Provider Enumeration Date	:	07/09/2010
Last Update Date	:	07/09/2010

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