Individual
CHAD WIERLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
9040 JACKSON AVE, JOINT BASE LEWIS MCCHORD, WA 98431-0001
(253) 968-4035
Mailing address
9040 JACKSON AVE, JOINT BASE LEWIS MCCHORD, WA 98431-0001
(253) 968-4035
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
00203294
CO
1223G0001X
General Practice Dentistry
Primary
00203294
CO
Other
Enumeration date
07/25/2017
Last updated
07/15/2026
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