John P Wiederholt DMD

NPI 1336369073 - Dentist - 122300000X

NPI Details
NPI 1336369073
Gender Male
Enumeration Date 04/26/2007
Last Updated 10/04/2011
Entity Type Individual
Active Over 9 years ago
Practice Location
3434 E. WASHINGTON AVE
MADISON WI, 53704-4155, US
Phone (608) 443-5550
Fax (608) 443-5554
Business Location
2901 W. BELTLINE HWY.
STE. 120
MADISON WI, 53713-4226, US
Phone (608) 443-5500
Fax (608) 441-1981
Toxanomy
Taxonomy Code 122300000X
License State Wisconsin
License Number 6263-015
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According to our database, Mr. John P Wiederholt DMD NPI is 1336369073, taxonomy code is 122300000X and license number is 6263-015, license state is located at Wisconsin. John P Wiederholt DMD physically located at 3434 E. Washington Ave, Madison WI, 53704-4155. NPI Number John P Wiederholt DMD has the Individual type.

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1336369073 NPI number is provided on an as is basis without warranty of any kind. 1336369073 is maintained by the National Plan & Provider Enumeration System. The contents of John P Wiederholt DMD are for informational purposes only.