Provider Demographics
NPI:1861658924
Name:NEMCEK, PAUL A (DDS)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:A
Last Name:NEMCEK
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 1:3000 N BROOKFIELD RD
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53045-3023
Mailing Address - Country:US
Mailing Address - Phone:262-786-0004
Mailing Address - Fax:
Practice Address - Street 1:3000 N BROOKFIELD RD
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53045-3023
Practice Address - Country:US
Practice Address - Phone:262-786-0004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-29
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL3991122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist