Provider Demographics
NPI:1386850790
Name:G.D. PIONEK,D.D.S.,S.C.
Entity Type:Organization
Organization Name:G.D. PIONEK,D.D.S.,S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:PIONEK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:1920-437-8116
Mailing Address - Street 1:1825 S WEBSTER AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54301-2280
Mailing Address - Country:US
Mailing Address - Phone:192-043-7811
Mailing Address - Fax:
Practice Address - Street 1:1825 S WEBSTER AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54301-2280
Practice Address - Country:US
Practice Address - Phone:192-043-7811
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty