Organization
NEW YORK UNIVERSITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS G. WIEDEMANN MD, DMD (CLINICAL ASSISTANT PROFESSOR)
(212) 998-9667
Entity
Organization
Contact information
Practice address
345 E 24TH ST, NEW YORK, NY 10010-4020
(212) 998-9667
(212) 995-4920
Mailing address
345 E 24TH ST, NEW YORK, NY 10010-4020
(212) 998-9667
(212) 995-4920
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
—
—
Other
Enumeration date
03/18/2016
Last updated
03/18/2016
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