W&w Dentistry

NPI #1003229659 in Grand Rapids, Michigan

Provider Information

NPI Number: 1003229659
Entity Type: Organization
Organization Name: W&w Dentistry
Primary Specialty: Dentist
Enumeration Date: Jun 10, 2014
Last Updated: Jun 10, 2014

Practice Location

Address: 2000 43RD ST SE
Address 2: SUITE C
City: Grand Rapids
State: Michigan
ZIP Code: 49508-8700
Phone: (616) 455-4108

Authorized Official

Name: DR. BRIAN A WIEDEMER, DDS
Title: MEMBER
Phone: (616) 455-4108

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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