Individual
DR. RONALD DAVID WISMER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
14125 SW FARMINGTON RD, BEAVERTON, OR 97005-2567
(503) 646-3169
(503) 646-1667
Mailing address
14125 SW FARMINGTON RD, BEAVERTON, OR 97005-2567
(503) 646-3169
(503) 646-1667
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4284
OR
Other
Enumeration date
06/20/2005
Last updated
07/08/2007
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