Individual
DR. DANNEL VERNON WIELGUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1789 SHAWANO AVE, GREEN BAY, WI 54303-3243
(920) 494-2310
(920) 494-6830
Mailing address
1789 SHAWANO AVE, GREEN BAY, WI 54303-3243
(920) 494-2310
(920) 494-6830
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4595
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33732200
—
WI
Enumeration date
09/25/2006
Last updated
07/08/2007
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