Individual
BRETT DAVID WICKERSHEIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1504 4TH ST NE, WASECA, MN 56093-2721
(507) 835-1080
Mailing address
1504 4TH ST NE, WASECA, MN 56093-2721
(507) 835-1080
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D14930
MN
Other
Enumeration date
07/13/2023
Last updated
07/17/2023
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