Lysak, Adam

Lysak, Adam is an individual health care provider with primary practice located at 457 W Grand Ave , Port Washington WI 53074-2143. He recently has only one registered license in Student, Health Care / Student in an Organized Health Care Education/Training Program, which is considered as his primary health care specialty. Lysak, Adam can be contacted via phone (262) 284-9011.

Contact Information

Primary practice address
457 W Grand Ave Port Washington WI 53074-2143
Phone: (262) 284-9011
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X

Profile Details

NPI number 1629569553
LBN Legal business name Lysak, Adam
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date May 26th, 2018
Last updated May 26th, 2018 - about 7 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.

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