Individual
SIDNEY CHARLES WISDOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS MS
Contact information
Practice address
2350 PROFESSIONAL DR, SUITE 300, ROSEVILLE, CA 95661
(916) 783-5239
(916) 783-5863
Mailing address
2350 PROFESSIONAL DR, SUITE 300, ROSEVILLE, CA 95661
(916) 783-5239
(916) 783-5863
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
33877
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
33877
CA
Other
Enumeration date
09/11/2006
Last updated
09/28/2021
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