Healthcare Provider Details

I. General information

NPI: 1023118973
Provider Name (Legal Business Name): DONALD ALLEN KWARCIANY DDS MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: DONALD ALLEN KWARCIANY DDS MS

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 03/01/2026
Certification Date: 03/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11035 W FOREST HOME AVE 116
HALES CORNERS WI
53130
US

IV. Provider business mailing address

11035 W FOREST HOME AVE 116
HALES CORNERS WI
53130
US

V. Phone/Fax

Practice location:
  • Phone: 414-529-1110
  • Fax: 414-529-1134
Mailing address:
  • Phone: 414-529-1110
  • Fax: 414-529-1134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2901014807
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number4883015
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: