| Dr Clarence E Kusik, | |
|
N50 W34838 Wisconsin Ave., Okauchee, WI 53069 | |
| (262) 567-3171 | |
| Not Available |
| Full Name | Dr Clarence E Kusik |
|---|---|
| Gender | Male |
| Speciality | Dentist |
| Location | N50 W34838 Wisconsin Ave., Okauchee, Wisconsin |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245407550 | NPI | - | NPPES |
| 33506100 | Medicaid | WI | |
| 1831369008 | Other | MAYFAIR DENTAL S.C. | |
| 38380800 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 5000432015 (Wisconsin) | Primary |
| 261QD0000X | Clinic/center - Dental | 5000432-15 (Wisconsin) | Secondary |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Clarence E Kusik, N50 W34838 Wisconsin Ave., Okauchee, WI 53069 Ph: (262) 567-3171 | Dr Clarence E Kusik, N50 W34838 Wisconsin Ave., Okauchee, WI 53069 Ph: (262) 567-3171 |
Brian G Bergmann, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: N50w34770 Wisconsin Ave, Okauchee, WI 53069 Phone: 262-567-0770 Fax: 262-567-0851 | |
Dr. Gottfried Hohm, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: N50w34770 Wisconsin Ave, Okauchee, WI 53069 Phone: 262-567-0770 Fax: 262-567-0851 |