Adam Lysak, DDS - Port Washington, WI

Adam Lysak, DDS

Student in an Organized Health Care Education/Training Program in Port Washington, Wisconsin

NPI 1629569553

Adam Lysak is a Student in an Organized Health Care Education/Training Program based in Port Washington, WI. Adam Lysak practices in Port Washington, WI and has the professional credentials of DDS. The NPI Number for Adam Lysak is 1629569553 and holds a License No. (Wisconsin).

The current practice location address for Adam Lysak is 457 W Grand Ave, Port Washington, WI and can be reached out via phone at 262-284-9011.

Location: 457 W Grand Ave, Port Washington, WI, 53074-2143

NPI Number

1629569553

Provider Name

Adam Lysak

Credential

DDS

Provider Entity Type

Individual

Gender

Male

Address

457 W Grand Ave, Port Washington, WI, 53074-2143

Phone Number

262-284-9011

Fax Number

Provider Enumeration Date

05/26/2018

Last Update Date

03/10/2024

Address

457 W Grand Ave

City

Port Washington

State

Wisconsin

Zip

53074-2143

Phone Number

262-284-9011

Fax Number

Address

457 W Grand Ave

City

Port Washington

State

Wisconsin

Zip

53074-2143

Phone Number

262-284-9011

Fax Number

Type

Student, Health Care

Classification

Student in an Organized Health Care Education/Training Program

Speciality

Taxonomy

390200000X

License No.

()

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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