Individual
DR. THOMAS PHILIP WANEZEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3278 MAIN STREET, EAST TROY, WI 53120
(262) 642-5881
Mailing address
PO BOX 15, EAST TROY, WI 53120-0015
(262) 642-5881
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5613-015
WI
Other
Enumeration date
06/12/2008
Last updated
06/12/2008
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