Eric J Wisdom, DDS Valid NPI
Individual provider · General Practice Dentistry · Manhattan, KS
- NPI
- 1902822596
- Type
- Individual (Type 1)
- Primary specialty
- General Practice Dentistry (Dentist)
- Specialty group
- Dental Providers
- Taxonomy code
- 1223G0001X
- License number
- 5188 (KS)
- Sex
- Male
- Sole proprietor
- No
- Enumerated
- 2006-07-15
- Last updated
- 2012-11-29
Practice location
1629 Poyntz Ave
Manhattan, KS 66502-4148
(785) 776-1771