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NPI Code Detail

MEDICARE: G.D. PIONEK,D.D.S.,S.C.

MEDICARE: G.D. PIONEK,D.D.S.,S.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223X0400XOrthodontics and Dentofacial Orthopedics DentistryWI

General Provider Information

NPI Number : 1386850790
Entity Type Code : Organization
Provider Name (Legal Business Name) : G.D. PIONEK,D.D.S.,S.C.
Provider Business Mailing Address
First Line : 1825 S WEBSTER AVE
Second Line : SUITE 201
City : GREEN BAY
State : WI
Zip : 54301-2280
Country : US
Telephone Number : 192-043-7811
Fax Number :
Provider Business Practice Location Address
First Line : 1825 S WEBSTER AVE
Second Line : SUITE 201
City : GREEN BAY
State : WI
Zip : 54301-2280
Country : US
Telephone Number : 192-043-7811
Fax Number :
Authorized Official
Title or Position : CEO
Name : DR. GERALD DAVID PIONEK
Credential : D.D.S.
Telephone Number : 19204378116
Provider Enumeration Date : 05/15/2007
Last Update Date : 08/22/2020

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