Provider Demographics
NPI:1760790596
Name:WNEK, JOSEPH S (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:S
Last Name:WNEK
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 1:103 S ELM ST
Mailing Address - Street 2:
Mailing Address - City:THREE OAKS
Mailing Address - State:MI
Mailing Address - Zip Code:49128-1123
Mailing Address - Country:US
Mailing Address - Phone:269-756-5431
Mailing Address - Fax:
Practice Address - Street 1:3650 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46545-3114
Practice Address - Country:US
Practice Address - Phone:574-258-4344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-14
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010202711223G0001X
IL019.0280261223G0001X
IN1201277A1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No1223G0001XDental ProvidersDentistGeneral Practice