Provider Demographics
NPI:1164406575
Name:PIANTEK, ANTON A (DDS)
Entity Type:Individual
Prefix:
First Name:ANTON
Middle Name:A
Last Name:PIANTEK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:TONY
Other - Middle Name:A
Other - Last Name:PIANTEK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:115 ALPINE CT
Mailing Address - Street 2:
Mailing Address - City:SHAWANO
Mailing Address - State:WI
Mailing Address - Zip Code:54166-2041
Mailing Address - Country:US
Mailing Address - Phone:715-524-2127
Mailing Address - Fax:715-526-4035
Practice Address - Street 1:115 ALPINE CT
Practice Address - Street 2:
Practice Address - City:SHAWANO
Practice Address - State:WI
Practice Address - Zip Code:54166-2041
Practice Address - Country:US
Practice Address - Phone:715-524-2127
Practice Address - Fax:715-526-4035
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI40291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice