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General NPI Number Information
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NPI Number | 1679684732
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Entity Type | Organization
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Legal Business Name | MICHAEL WIENER, D.D.S., P.L.L.C.
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 11/20/2017
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Provider Practice Location Address
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Address Line | 1007 ROUTE 82
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City | HOPEWELL JUNCTION
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State | NY
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Zip | 12533-6165
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Country | US
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Telephone | 845-226-1000
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Fax | 845-226-1004
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Provider Business Mailing Address
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Address Line | PO BOX 130
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City | HOPEWELL JUNCTION
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State | NY
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Zip | 12533-0130
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Country | US
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Telephone | 845-226-1000
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Fax | 845-226-1004
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL WIENER
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Credential | D.D.S.
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Telephone | 845-226-1000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 047467-1
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License Number State | NY
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