Individual
JOHN R. WIENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1030 29TH AVE SW, ALBANY, OR 97321-3416
(541) 924-1190
Mailing address
PO BOX 399, ALBANY, OR 97321-0116
(559) 906-1984
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
62455
CA
1223E0200X
Endodontics
Primary
D11255
OR
Other
Enumeration date
07/11/2013
Last updated
07/31/2020
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