MEDICARE: MR. FRANKLIN FREDRICK WILEMAN R.D.H.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	124Q00000X	Dental Hygienist	6141-016	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043486228
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. FRANKLIN FREDRICK WILEMAN R.D.H.

Provider Business Mailing Address
First Line	:	1234 LLOYD CT
Second Line	:
City	:	CUSTER
State	:	WI
Zip	:	54423-9427
Country	:	US
Telephone Number	:	715-592-4704
Fax Number	:

Provider Business Practice Location Address
First Line	:	1234 LLOYD COURT
Second Line	:
City	:	CUSTER
State	:	WI
Zip	:	54423
Country	:	US
Telephone Number	:	715-592-4704
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/07/2008
Last Update Date	:	05/07/2008

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Directions to “ MR. FRANKLIN FREDRICK WILEMAN R.D.H.” Practice Location

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