Provider Demographics
NPI:1295871408
Name:OTTO JOHN VNEK, DDS, PC
Entity type:Organization
Organization Name:OTTO JOHN VNEK, DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:OTTO
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:VNEK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:207-725-4311
Mailing Address - Street 1:82 BARIBEAU DR
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-3241
Mailing Address - Country:US
Mailing Address - Phone:207-725-4311
Mailing Address - Fax:207-725-9849
Practice Address - Street 1:82 BARIBEAU DR
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-3241
Practice Address - Country:US
Practice Address - Phone:207-725-4311
Practice Address - Fax:207-725-9849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty