Individual
DR. CHRISTIAN R. WYSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
108 5TH AVE, DECORAH, IA 52101-1319
(563) 382-3657
(563) 382-0739
Mailing address
108 5TH AVE, DECORAH, IA 52101-1319
(563) 382-3657
(563) 382-0739
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5545
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0066621
—
IA
01
—
1681033
UNITED CONCORDIA ID
IA
Enumeration date
10/17/2006
Last updated
07/09/2007
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