Individual
ERIC WIEDEMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
200 MEDICAL DR STE A, CARMEL, IN 46032-2985
(317) 575-1995
Mailing address
200 MEDICAL DR STE A, CARMEL, IN 46032-2985
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12013644A
IN
Other
Enumeration date
06/14/2021
Last updated
06/14/2021
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