Individual
JONATHAN WISER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
860 LYNN ST, LEBANON, MO 65536-3810
(417) 334-8337
Mailing address
426 COBB DR, LEBANON, MO 65536
(480) 652-0846
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2025020240
MO
Other
Enumeration date
06/25/2025
Last updated
06/25/2025
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