DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DAVID D. WYSE, D.D.S., P.C.

Active Organization

Dental Clinic · BLOOMINGTON, IL

Registration Details

NPI Number
1124143896
Provider Type
Organization
NPI Issued
Mar 20, 2007 (19.107551192075 yrs)
Last Updated
Oct 3, 2013
License
060001892 (IL)

Practice Information

Address
207 S PROSPECT RD
STE. 2
BLOOMINGTON, IL, 617044905
Browse IL providers · Browse ZIP 61704
Phone
3096636393
Fax
3096640366
Primary Specialty
Dental Clinic
261QD0000X
Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.