Individual
DR. JEFFREY L WASIELEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
9416 S MAIN ST, STE 211, PLYMOUTH, MI 48170-4157
(734) 455-0710
(734) 455-4433
Mailing address
9416 S MAIN ST STE 211, PLYMOUTH, MI 48170-4183
(734) 478-0329
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2901017635
MI
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
2901017635
MI
Other
Enumeration date
07/27/2006
Last updated
07/23/2019
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