Organization
ANDREW R WISE DDS PC
Active
Other names
Andrew R Wise DDS Inc
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW R WISE DDS (OWNER PRESIDENT)
(707) 447-8289
Entity
Organization
Contact information
Practice address
1241 ALAMO DR, STE 11, VACAVILLE, CA 95687
(707) 447-8289
(707) 447-3769
Mailing address
1241 ALAMO DR, STE 11, VACAVILLE, CA 95687
(707) 447-8289
(707) 447-3769
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
45790
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
741169
UNITED CONCORDIA
—
Enumeration date
04/07/2006
Last updated
08/22/2020
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