| Michael R. Wiesner Dds Llc | |
|
385 Bert Kouns Loop Ste 700 Shreveport LA 71106-8163 | |
| (318) 688-9330 | |
| (318) 212-6539 |
| Full Name | Michael R. Wiesner Dds Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 385 Bert Kouns Loop Ste 700, Shreveport, Louisiana |
| Authorized Official Name and Position | Inger Whittington (INSURANCE BILLING LEAD) |
| Authorized Official Contact | 3186067622 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael R. Wiesner Dds Llc 2557 Viking Dr Bossier City LA 71111-2103 Ph: (318) 606-7622 | Michael R. Wiesner Dds Llc 385 Bert Kouns Loop Ste 700 Shreveport LA 71106-8163 Ph: (318) 688-9330 |
| NPI Number | 1750101606 |
|---|---|
| Provider Enumeration Date | 10/15/2024 |
| Last Update Date | 10/15/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750101606 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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