Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JOEL GREGORY WIERSUM SR., DDS
ActiveJOEL GREGORY WIERSUM SR., DDS is a Dentist healthcare provider located in KODIAK, Alaska. NPI 1467462341 is currently active in the NPPES registry. Verify at CMS.
Dentist · KODIAK, AK
Registration Details
- NPI Number
- 1467462341
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 9, 2006 (20.005818137296 yrs)
- Last Updated
- Jul 8, 2007
- License
-
AA799 (AK)
Practice Information
- Address
-
411 REZANOF DR ESUITE 101KODIAK, AK, 99615Browse AK providers · Browse ZIP 99615
- Phone
- 9074863475
- Fax
- 9074863427
- Primary Specialty
-
Dentist
122300000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.