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Individual

DAVID S. WIETING

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
122 WEST 6TH STREET, YORK, NE 68467
(402) 362-3379
(402) 362-3370
Mailing address
122 WEST 6TH STREET, YORK, NE 68467
(402) 362-3379
(402) 362-3370

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4785
NE
122300000X
Dentist
9889
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
47060373000
NE
Enumeration date
04/24/2012
Last updated
04/24/2012
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