Provider Demographics
NPI:1033213731
Name:WNEK, EDWARD J (DDS, MS, LLC)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:J
Last Name:WNEK
Suffix:
Gender:M
Credentials:DDS, MS, LLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2712 ERIE AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45208-2111
Mailing Address - Country:US
Mailing Address - Phone:513-871-0324
Mailing Address - Fax:513-871-2587
Practice Address - Street 1:2712 ERIE AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45208-2111
Practice Address - Country:US
Practice Address - Phone:513-871-0324
Practice Address - Fax:513-871-2587
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-01-50051223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics