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Individual

DR. LUCAS JAMES WIEBE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S

Contact information

Practice address
1110 W 5TH ST, CANTON, SD 57013-1543
(605) 987-2721
(605) 987-3312
Mailing address
PO BOX 9, CANTON, SD 57013-0009
(605) 987-2721
(605) 987-3312

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
606
SD

Other

Enumeration date
05/31/2016
Last updated
05/31/2016
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