MICHAEL R WIESNER

SHREVEPORT, LA
NPI1154524817
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: LA  5831)
Additional Taxonomies204E00000X Oral & Maxillofacial Surgery
(Licence: LA  5831)
Enumeration Date2007-06-08
Last Update Date2025-03-11
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
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