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General NPI Number Information
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NPI Number | 1902056872
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Entity Type | Individual
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Provider Name | DAVID L KUJAK DMD, MS
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Gender | Male
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Dates
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Enumeration Date | 09/26/2008
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Last Update Date | 01/17/2013
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Provider Practice Location Address
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Address Line | 1845 E MAIN ST
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City | ONALASKA
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State | WI
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Zip | 54650-8668
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Country | US
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Telephone | 608-783-8333
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Fax | 608-783-5942
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Provider Business Mailing Address
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Address Line | 1845 E MAIN ST
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City | ONALASKA
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State | WI
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Zip | 54650-8668
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Country | US
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Telephone | 608-783-8333
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Fax | 608-783-5942
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 8676
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DS9252
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 6949
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License Number State | WI
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