Individual
DR. THOMAS ERWIN TADYSAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
10610 MAIN ST, HAYWARD, WI 54843
(715) 638-3403
Mailing address
10634W CTY RD B, HAYWARD, WI 54843
(715) 462-9638
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5735015
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33788500
—
WI
Enumeration date
05/07/2007
Last updated
07/08/2007
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