Healthcare Provider Details

I. General information

NPI: 1215118443
Provider Name (Legal Business Name): PAULA R DUSZYNSKI DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2007
Last Update Date: 04/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3434 E. WASHINGTON AVE.
MADISON WI
53704-4155
US

IV. Provider business mailing address

2901 W BELTLINE HWY STE.120
MADISON WI
53713-4226
US

V. Phone/Fax

Practice location:
  • Phone: 608-443-5482
  • Fax: 608-443-5554
Mailing address:
  • Phone: 608-443-5500
  • Fax: 608-441-1981

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number5744-15
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: