Provider Demographics
NPI:1134270937
Name:WISNIEWSKI, JOHN FRANCIS (DMD)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:FRANCIS
Last Name:WISNIEWSKI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:150 PRESTON EXECUTIVE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-8485
Mailing Address - Country:US
Mailing Address - Phone:919-481-9414
Mailing Address - Fax:
Practice Address - Street 1:150 PRESTON EXECUTIVE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-8485
Practice Address - Country:US
Practice Address - Phone:919-481-9414
Practice Address - Fax:919-481-9017
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC75071223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics