Wiedeman, Richard William

Wiedeman, Richard William is an individual health care provider with primary practice located at 15 Jane Jacobs Rd Ste 201 , Black Mountain NC 28711-6308. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Wiedeman, Richard William can be contacted via phone (828) 210-7051.

Contact Information

Primary practice address
15 Jane Jacobs Rd Ste 201 Black Mountain NC 28711-6308
Phone: (828) 210-7051
Fax: (828) 210-7052
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 2015018392 Missouri
Dental Providers / General Practice 1223G0001X 7085 North Carolina

Profile Details

NPI number 1528102027
LBN Legal business name Wiedeman, Richard William
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 16th, 2007
Last updated May 1st, 2018 - about 8 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 1528102027 NPPES
North Carolina MEDICAID 89012MJ

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