Provider Demographics
NPI:1093849804
Name:SETNICAR, JOSEPH M (DDS)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:M
Last Name:SETNICAR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 SUMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:OCONOMOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:53066-3920
Mailing Address - Country:US
Mailing Address - Phone:262-567-4466
Mailing Address - Fax:262-567-5957
Practice Address - Street 1:820 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:OCONOMOWOC
Practice Address - State:WI
Practice Address - Zip Code:53066-3920
Practice Address - Country:US
Practice Address - Phone:262-567-4466
Practice Address - Fax:262-567-5957
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2721122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist