Individual
MARCUS D WISNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3920 S 1100 E STE 330, SALT LAKE CITY, UT 84124-1274
(801) 262-9785
Mailing address
3920 S 1100 E STE 330, SALT LAKE CITY, UT 84124-1274
(801) 262-9785
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5079227
UT
Other
Enumeration date
04/10/2007
Last updated
07/08/2007
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