Organization
WANEZEK FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHILIP M WANEZEK DDS (DENTIST OWNER)
(262) 642-5881
Entity
Organization
Contact information
Practice address
W3278 MAIN STREET, EAST TROY, WI 53120
(262) 642-5881
(262) 642-7252
Mailing address
PO BOX 15, EAST TROY, WI 53120
(262) 642-5881
(262) 642-7252
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/02/2007
Last updated
08/22/2020
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