Individual
DR. MARK LEONARD WIESNER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
6900 GEORGIA AVE. NW, BUILDING 2, ROOM 1D02, WASHINGTON, DC 20307-5400
(202) 782-6815
(202) 782-6987
Mailing address
6900 GEORGIA AVE. NW, BUILDING T20, ROOM 206A, WASHINGTON, DC 20307-5400
(202) 782-0988
(202) 782-9195
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10757
MD
Other
Enumeration date
12/09/2005
Last updated
07/08/2007
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