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NPI Code Detail

MEDICARE: DR. R CONSTANCE WIENER DMD

MEDICARE:  DR. R CONSTANCE  WIENER  DMD
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
1122300000XDentist3741WV

General Provider Information

NPI Number : 1285616474
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. R CONSTANCE WIENER DMD
Provider Business Mailing Address
First Line : 1 MED CENTER DR
Second Line :
City : MORGANTOWN
State : WV
Zip : 26507
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1 MED CENTER DR
Second Line :
City : MORGANTOWN
State : WV
Zip : 26507
Country : US
Telephone Number : 304-581-1960
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2005
Last Update Date : 12/05/2012

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Directions to “ DR. R CONSTANCE WIENER DMD” Practice Location

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