MICHAEL R WIESNER

SHREVEPORT, LA
NPI1154524817
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: LA  5831)
Enumeration Date2007-06-08
Last Update Date2014-12-09
Business Address
-- MICHAEL R WIESNER D.D.s
385 BERT KOUNS LOOP STE 700
SHREVEPORT, LA 71106-8163
Phone number: 318-688-9330
Mailing Address
-- MICHAEL R WIESNER D.D.s
385 BERT KOUNS LOOP STE 700
SHREVEPORT, LA 71106-8163
Phone number: 318-779-1254