Organization
NATHANIEL WIEDER, DMD, P.C.
Active
Organization
NATHANIEL WIEDER, DMD, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATHANIEL WIEDER D.M.D. (PRESIDENT)
(516) 316-4480
Entity
Organization
Contact information
Practice address
390 BERRY ST, SUITE B, BROOKLYN, NY 11249-6084
(718) 218-7210
Mailing address
390 BERRY ST, SUITE B, BROOKLYN, NY 11249-6084
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
058348-1
NY
Other
Enumeration date
07/29/2016
Last updated
07/29/2016
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