Individual
DR. PHILIP M WANEZEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
3278 MAIN ST, SUITE A, EAST TROY, WI 53120-1152
(262) 642-5881
(262) 642-7252
Mailing address
PO BOX 15, EAST TROY, WI 53120-0015
(262) 642-5881
(262) 642-7252
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2513-015
WI
Other
Enumeration date
10/07/2014
Last updated
10/07/2014
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