Organization
WIESEMANN ORTHODONTICS INC. PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN B. WIESEMANN DMD,MS (ORTHODONTISTS/OWNER)
(615) 325-4677
Entity
Organization
Contact information
Practice address
894 FRED LIVELY RD, BOWLING GREEN, KY 42104-7424
(616) 325-4677
Mailing address
323 WEST DR, WHITE HOUSE, TN 37188-9294
(615) 325-4677
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
8503
TN
Other
Enumeration date
05/31/2011
Last updated
05/31/2011
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