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1104814029
NICHOLAS WIESE
FARIBAULT, MN
NPI
1104814029
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
122300000X Dentist
(Licence: MN D11401)
Enumeration Date
2005-10-13
Last Update Date
2007-07-08
Business Address
Dr. NICHOLAS WIESE D.D.S.
417 LINCOLN AVE NW
FARIBAULT, MN 55021-4952
Phone number: 507-332-7608
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Mailing Address
Dr. NICHOLAS WIESE D.D.S.
417 LINCOLN AVE NW
FARIBAULT, MN 55021-4952
Phone number: 507-332-7608
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