Organization
WIGHTMAN FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK JOSEPH WIGHTMAN DDS (DENTIST/OWNER)
(504) 272-0870
Entity
Organization
Contact information
Practice address
2212 PARIS RD, CHALMETTE, LA 70043-5025
(504) 272-0870
(504) 302-9054
Mailing address
2212 PARIS RD, CHALMETTE, LA 70043-5025
(504) 272-0870
(504) 302-9054
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
5746
LA
1223G0001X
General Practice Dentistry
Primary
5747
LA
Other
Enumeration date
06/25/2008
Last updated
06/25/2008
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