Individual
MR. RICHARD L WIEDOWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
810 SALEM RD, CONWAY, AR 72034
(501) 327-9988
(501) 327-9991
Mailing address
810 SALEM RD, CONWAY, AR 72034
(501) 327-9988
(501) 327-9991
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
AR2704
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
59167
BCBS
AR
01
—
849711
UCCI
—
Enumeration date
08/13/2006
Last updated
07/08/2007
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