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1124143896
DAVID D. WYSE, D.D.S., P.C.
BLOOMINGTON, IL
NPI
1124143896
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Entity Type
Organization
Authorized Contact
DAVID D. WYSE
Owner
309-663-6393
Organization Subpart ?
No
Primary Taxonomy
261QD0000X Clinic/Center Dental
(Licence: IL 060001892)
Enumeration Date
2007-03-20
Last Update Date
2013-10-03
Business Address
DAVID D. WYSE, D.D.S., P.C.
207 S PROSPECT RD STE. 2
BLOOMINGTON, IL 61704-4905
Phone number: 309-663-6393
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Mailing Address
DAVID D. WYSE, D.D.S., P.C.
207 S PROSPECT RD STE. 2
BLOOMINGTON, IL 61704-4905
Phone number: 309-663-6393
Copy
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