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General NPI Number Information
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NPI Number | 1205455490
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Entity Type | Individual
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Provider Name | WILLIAM WIERING DDS
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Gender | Male
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Dates
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Enumeration Date | 04/09/2020
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Last Update Date | 10/14/2024
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Provider Practice Location Address
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Address Line | 200 S BOLTWOOD ST
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City | HASTINGS
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State | MI
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Zip | 49058-1926
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Country | US
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Telephone | 269-945-4220
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Fax |
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Provider Business Mailing Address
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Address Line | 200 S BOLTWOOD ST
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City | HASTINGS
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State | MI
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Zip | 49058-1926
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Country | US
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Telephone | 269-945-4220
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 00204338
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 00204338
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2901601789
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License Number State | MI
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