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Individual
DAVID S. WIETING
Active
Individual
DAVID S. WIETING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4785
NE
122300000X
Dentist
9889
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47060373000
—
NE
Enumeration date
04/24/2012
Last updated
04/24/2012
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