# ROBERT WIESEN DDS MS PLLC

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

## Provider details

- **NPI number:** 1831957562
- **Authorized official:** DR. ROBERT MICHAEL WIESEN JR. DDS, MS (ENDODONTIST)
- **Authorized official phone:** (810) 584-7275

## Contact information

- **Practice address:** 8235 HOLLY RD STE 2, GRAND BLANC, MI 48439-2441
- **Practice address phone:** (810) 584-7275
- **Mailing address:** 8235 HOLLY RD STE 2, GRAND BLANC, MI 48439-2441
- **Mailing address phone:** (810) 584-7275

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | — | — | Yes |

## Other

- **Enumeration date:** 03/07/2024
- **Last updated:** 05/24/2024