Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 30-01-5005 | OH |
NPI | 1033213731 |
---|---|
Provider Name | Edward J. Wnek |
First Address | Cincinnati, OH 45208-2111 |
Second Address | Cincinnati, OH 45208-2111 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2006 |
Last Update Date | 08/07/2007 |