Provider Demographics
NPI:1326249152
Name:NOSEK, DENNIS ROY (DDS)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:ROY
Last Name:NOSEK
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 1:1920 W HART RD
Mailing Address - Street 2:
Mailing Address - City:BELOIT
Mailing Address - State:WI
Mailing Address - Zip Code:53511-2231
Mailing Address - Country:US
Mailing Address - Phone:608-362-2414
Mailing Address - Fax:
Practice Address - Street 1:1920 W HART RD
Practice Address - Street 2:
Practice Address - City:BELOIT
Practice Address - State:WI
Practice Address - Zip Code:53511-2231
Practice Address - Country:US
Practice Address - Phone:608-362-2414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI50003331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice