Individual
DR. MARK JOSEPH WIESEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
450 SUTTER ST, SUITE 2400, SAN FRANCISCO, CA 94108-4206
(415) 989-0550
(415) 989-0554
Mailing address
450 SUTTER ST, SUITE 2400, SAN FRANCISCO, CA 94108-4206
(415) 989-0550
(415) 989-0554
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
44640
CA
Other
Enumeration date
02/12/2007
Last updated
07/08/2007
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