Individual
CHAD WIERLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
652 HAMILTON RD, USA DENTAL HEALTH ACTIVITY, FORT SILL, OK 73503
(580) 442-3905
Mailing address
USA DENTAL HEALTH ACTIVITY 652 HAMILTON RD, FORT SILL, OK 73503
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
00203294
CO
Other
Enumeration date
07/25/2017
Last updated
07/25/2017
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