Provider Demographics
NPI:1457005969
Name:VIETH, DENNIS
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:
Last Name:VIETH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2042 BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:SUN PRAIRIE
Mailing Address - State:WI
Mailing Address - Zip Code:53590-9665
Mailing Address - Country:US
Mailing Address - Phone:608-630-2408
Mailing Address - Fax:
Practice Address - Street 1:2042 BRANCH RD
Practice Address - Street 2:
Practice Address - City:SUN PRAIRIE
Practice Address - State:WI
Practice Address - Zip Code:53590-9665
Practice Address - Country:US
Practice Address - Phone:608-630-2408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-04
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications