Brusky, David J.
Brusky, David J. is an sole proprietor health care provider with primary practice located at 410 Security Blvd , Green Bay WI 54313-9705. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Brusky, David J. can be contacted via phone (920) 662-1440.Contact Information
Primary practice address
410 Security Blvd
Green Bay WI 54313-9705
Phone: (920) 662-1440
Fax: (920) 662-1443
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 4498-015 | Wisconsin |
Profile Details
| NPI number | 1962619957 |
|---|---|
| LBN Legal business name | Brusky, David J. |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 17th, 2007 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1962619957 | NPPES |
| Wisconsin | MEDICAID | 33797600 |
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