# DAVID S. WIENER D.D.S. & ROBERT L. WAGNER DMD P.LL.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306181847
- **Authorized official:** DR. DAVID STEVEN WIENER DDS. (DR./PARTNER)
- **Authorized official phone:** (631) 265-3132

## Contact information

- **Practice address:** 200 EAST MAIN ST., SUITE 4E, SMITHTOWN, NY 11787
- **Practice address phone:** (631) 265-3132
- **Practice address fax:** (631) 265-3209
- **Mailing address:** 200 EAST MAIN ST., SUITE 4E, SMITHTOWN, NY 11787
- **Mailing address phone:** (631) 265-3132
- **Mailing address fax:** (631) 265-3209

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223D0001X | Public Health Dentistry | — | NULL | Yes |
| 1223D0001X | Public Health Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 12/11/2012
- **Last updated:** 12/11/2012