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Individual

DR. PETER E. WIESEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
222 NEW ROAD, SUITE #401, LINWOOD, NJ 08221
(609) 927-5300
(609) 927-6731
Mailing address
222 NEW ROAD, SUITE #401, LINWOOD, NJ 08221
(609) 927-5300
(609) 927-6731

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22DD101628200
NJ
1223P0700X
Prosthodontics
3554
NJ

Other

Enumeration date
09/29/2009
Last updated
09/29/2009
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