Provider Demographics
NPI:1851070072
Name:CWIEK, CAROLINE (DMD)
Entity Type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:
Last Name:CWIEK
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2141 S FINLEY RD APT 607
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-6464
Mailing Address - Country:US
Mailing Address - Phone:732-692-0371
Mailing Address - Fax:
Practice Address - Street 1:60C MAIN ST
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:IL
Practice Address - Zip Code:60543-8594
Practice Address - Country:US
Practice Address - Phone:630-554-1855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-14
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0345061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty