Individual
DR. KENNETH J. WISSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
G5399 N SAGINAW ST, FLINT, MI 48505-1536
(810) 785-0863
(810) 785-0865
Mailing address
225 E 5TH ST, SUITE 300, FLINT, MI 48502-1641
(810) 406-4912
(810) 424-6029
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
D10989 040
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
382406558
TAX ID
MI
Enumeration date
04/06/2006
Last updated
10/15/2009
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