Provider Demographics
NPI:1730310145
Name:WINEGAR, JOSEPH WILLIAM (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:WILLIAM
Last Name:WINEGAR
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 1:4255 PHEASANT RIDGE DR NE
Mailing Address - Street 2:
Mailing Address - City:BLAINE
Mailing Address - State:MN
Mailing Address - Zip Code:55449-4537
Mailing Address - Country:US
Mailing Address - Phone:763-225-6100
Mailing Address - Fax:
Practice Address - Street 1:4255 PHEASANT RIDGE DR NE
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55449-4537
Practice Address - Country:US
Practice Address - Phone:763-225-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-03
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND126991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice