Wiener, Michael J

Wiener, Michael J is an sole proprietor health care provider with primary practice located at 921 State St , New Haven CT 06511-3926. He recently has only one registered license in Dental Providers / Periodontics, which is considered as his primary health care specialty. Wiener, Michael J can be contacted via phone (203) 865-2245.

Contact Information

Primary practice address
921 State St New Haven CT 06511-3926
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Periodontics 1223P0300X 008178 Connecticut

Profile Details

NPI number 1013053271
LBN Legal business name Wiener, Michael J
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 29th, 2007
Last updated May 5th, 2014 - about 10 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 1013053271 NPPES
Connecticut MEDICAID 008001172

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