Provider Demographics
NPI:1730397209
Name:TREWEEK, THOMAS WILLIAM (DDS)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:WILLIAM
Last Name:TREWEEK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 247
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:WI
Mailing Address - Zip Code:54411-0247
Mailing Address - Country:US
Mailing Address - Phone:715-257-9278
Mailing Address - Fax:
Practice Address - Street 1:317 WASHINGTON ST.
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:WI
Practice Address - Zip Code:54411-0247
Practice Address - Country:US
Practice Address - Phone:715-257-9278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2368122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI2368OtherDENTAL LICENSE NUMBER