Individual
DR. CARLOS GUILLERMO WIESSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4116 S CARRIER PKWY STE 320, GRAND PRAIRIE, TX 75052-3243
(972) 262-5522
(972) 262-5549
Mailing address
4116 S CARRIER PKWY STE 320, GRAND PRAIRIE, TX 75052-3243
(972) 262-5522
(972) 262-5549
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
15548
TX
Other
Enumeration date
08/02/2006
Last updated
07/08/2007
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