| Wiesemann Orthodontics Inc. Pc | |
|
894 Fred Lively Rd Bowling Green KY 42104-7424 | |
| (616) 325-4677 | |
| Not Available |
| Full Name | Wiesemann Orthodontics Inc. Pc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 894 Fred Lively Rd, Bowling Green, Kentucky |
| Authorized Official Name and Position | Ryan B. Wiesemann (ORTHODONTISTS/OWNER) |
| Authorized Official Contact | 6153254677 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wiesemann Orthodontics Inc. Pc 323 West Dr White House TN 37188-9294 Ph: (615) 325-4677 | Wiesemann Orthodontics Inc. Pc 894 Fred Lively Rd Bowling Green KY 42104-7424 Ph: (616) 325-4677 |
| NPI Number | 1740574458 |
|---|---|
| Provider Enumeration Date | 05/31/2011 |
| Last Update Date | 05/31/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740574458 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 8503 (Tennessee) | Primary |
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