Healthcare Provider Details

I. General information

NPI: 1346331741
Provider Name (Legal Business Name): JOSEPH WILLIAM LASNOSKI DDS MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

138 SIEGLER ST
GREEN BAY WI
54303
US

IV. Provider business mailing address

138 SIEGLER ST
GREEN BAY WI
54303
US

V. Phone/Fax

Practice location:
  • Phone: 920-499-9958
  • Fax: 920-499-1492
Mailing address:
  • Phone: 920-499-9958
  • Fax: 920-499-1492

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number2901015553
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number5001473015
License Number StateWI
# 3
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number2901015553
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: