Individual
DR. BRIAN WICENSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
27 NEWPORT ROAD, NEW LONDON, NH 03257-1017
(603) 526-2286
Mailing address
PO BOX 1017, NEW LONDON, NH 03257-1017
(603) 526-9311
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3019
NH
Other
Enumeration date
12/11/2006
Last updated
07/08/2007
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