Individual
ROBIN RICHARD WIEDERRICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.D
Contact information
Practice address
9323 MCKENNA FALLS RD W, BREMERTON, WA 98312-9730
(360) 277-0964
(360) 277-0967
Mailing address
9323 MCKENNA FALLS RD W, BREMERTON, WA 98312-9730
(360) 277-0964
(360) 277-0967
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
DN00000371
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5046198
—
WA
Enumeration date
05/13/2008
Last updated
05/13/2008
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