Individual
JACOB WIESEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
306 S 4TH ST STE 100, SEWARD, NE 68434-2533
(402) 643-2931
Mailing address
528 WOODSAGE RD, SEWARD, NE 68434-8113
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8212
NE
Other
Enumeration date
06/04/2026
Last updated
06/04/2026
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