Individual
DR. DANA MARIE WISSEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2045 MADRONA AVE SE # 150, SALEM, OR 97302-1149
(503) 809-4784
Mailing address
3490 NW DEER RUN ST, CORVALLIS, OR 97330-3111
(541) 740-7576
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D11619
OR
Other
Enumeration date
06/13/2022
Last updated
06/13/2022
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