Individual
JENNIFER WISMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
142 JORALEMON ST STE 12C, BROOKLYN, NY 11201-4709
(718) 625-2116
Mailing address
474 HENRY ST APT 4, BROOKLYN, NY 11231-3027
(646) 912-5724
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
061395-01
NY
Other
Enumeration date
04/07/2019
Last updated
09/02/2021
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