Individual
MR. GARY BRIAN WIELE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2821 N BALLAS RD, STE 260, ST LOUIS, MO 63131
(314) 475-5333
(314) 475-5334
Mailing address
2821 N BALLAS RD, STE 260, ST LOUIS, MO 63131
(314) 475-5333
(314) 475-5334
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
13937
MO
Other
Enumeration date
09/28/2006
Last updated
09/01/2023
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