Provider Demographics
NPI:1811066137
Name:WEST NEW BROOK ORTHODONTISTS
Entity type:Organization
Organization Name:WEST NEW BROOK ORTHODONTISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:PINCSAK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:262-798-1421
Mailing Address - Street 1:20855 WATERTOWN RD
Mailing Address - Street 2:SUITE 240
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53186
Mailing Address - Country:US
Mailing Address - Phone:262-798-1421
Mailing Address - Fax:262-798-1494
Practice Address - Street 1:20855 WATERTOWN RD
Practice Address - Street 2:SUITE 240
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53186
Practice Address - Country:US
Practice Address - Phone:262-798-1421
Practice Address - Fax:262-798-1494
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty