Individual
DR. DAVID J. BRUSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
410 SECURITY BLVD, GREEN BAY, WI 54313-9705
(920) 662-1440
(920) 662-1443
Mailing address
410 SECURITY BLVD, GREEN BAY, WI 54313-9705
(920) 662-1440
(920) 662-1443
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4498-015
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33797600
—
WI
Enumeration date
05/17/2007
Last updated
07/08/2007
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