Individual
DR. JOHN SCOTT WIENCEK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
114 E WASHINGTON ST, STOUGHTON, WI 53589-1736
(608) 873-7412
(608) 873-7342
Mailing address
114 E WASHINGTON ST, STOUGHTON, WI 53589-1736
(608) 873-7412
(608) 873-7342
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3244015
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33465000
—
WI
Enumeration date
10/06/2005
Last updated
07/08/2007
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