Individual
CHRISTOPHER J BACSIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
5801 RESEARCH PARK BLVD, STE 110, MADISON, WI 53719-6002
(608) 274-0770
(608) 274-9224
Mailing address
1306 RED TAIL DR, VERONA, WI 53593-7964
(608) 848-0510
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
5448-015
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13127
DEAN HEALTH PLAN ID#
WI
05
—
33738600
—
WI
Enumeration date
06/23/2006
Last updated
07/09/2007
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