Wiedemer, Brian A.

Wiedemer, Brian A. is an individual health care provider with primary practice located at 86-260 Farrington Hwy , Waianae HI 96792-3128. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Wiedemer, Brian A. can be contacted via phone (808) 697-3496.

Contact Information

Primary practice address
86-260 Farrington Hwy Waianae HI 96792-3128
Phone: (808) 697-3496
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 2901019234 Michigan
Dental Providers / General Practice 1223G0001X CSDT-38 Hawaii

Profile Details

NPI number 1730293549
LBN Legal business name Wiedemer, Brian A.
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 18th, 2006
Last updated May 15th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730293549 NPPES
Michigan Other 19234-MI DELTA DENTAL
Michigan MEDICAID 4823188 DELTA DENTAL

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