Organization
MICHAEL R. WIESNER DDS LLC
Active
Other names
A Brighter Smile Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
INGER WHITTINGTON (INSURANCE BILLING LEAD)
(318) 606-7622
Entity
Organization
Contact information
Practice address
385 BERT KOUNS LOOP STE 700, SHREVEPORT, LA 71106-8163
(318) 688-9330
(318) 212-6539
Mailing address
2557 VIKING DR, BOSSIER CITY, LA 71111-2103
(318) 606-7622
(318) 212-6539
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/15/2024
Last updated
10/15/2024
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