Individual
RYAN WILLIAM WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
9532 GREAT SMOKEY AVE, BATON ROUGE, LA 70814-4103
(225) 892-4909
Mailing address
9532 GREAT SMOKEY AVE, BATON ROUGE, LA 70814-4103
(225) 892-4909
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D.007187-C1
AL
Other
Enumeration date
03/24/2023
Last updated
07/09/2023
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