Organization
CARLOS WIESSE, DDS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARLOS WIESSE (DENTIST)
(817) 649-8888
Entity
Organization
Contact information
Practice address
5535 LAKE RIDGE PKWY, GRAND PRAIRIE, TX 75052-8515
(817) 649-8888
(817) 649-8889
Mailing address
5535 LAKE RIDGE PKWY, GRAND PRAIRIE, TX 75052-8515
(817) 649-8888
(817) 649-8889
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
15548
TX
Other
Enumeration date
02/09/2015
Last updated
02/09/2015
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