Provider Demographics
NPI:1962553305
Name:N.E.W. SNORING & SLEEP APNEA CENTER, S.C.
Entity type:Organization
Organization Name:N.E.W. SNORING & SLEEP APNEA CENTER, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:E
Authorized Official - Last Name:PATRICKUS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:920-468-4646
Mailing Address - Street 1:PO BOX 9731
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54308-9731
Mailing Address - Country:US
Mailing Address - Phone:920-468-4646
Mailing Address - Fax:
Practice Address - Street 1:2343 E MASON ST
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54302-3764
Practice Address - Country:US
Practice Address - Phone:920-468-4646
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-14
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI000076990Medicare PIN