Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 5744-15 | WI |
NPI | 1215118443 |
---|---|
Provider Name | Ms. Paula R Duszynski |
First Address | Madison, WI 53713-4226 |
Second Address | Madison, WI 53704-4155 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2007 |
Last Update Date | 10/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
33810700 | (05) | WI |