NPI 1003451642

Brian Matthew Wiacek, DMD

Practitioner Dentist Frederick, MD

Practice location

Address: 7115 Guilford Dr STE 101, Frederick, MD 21704-5234
Phone: (240) 379-1550

Registered specialties

Dentist Primary

Dental Providers Taxonomy 122300000X Licence 17917 (MD)

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Registry record

NPI: 1003451642
Entity type: Individual
Sex (as registered): Male
NPI issued: 7 Nov 2019
Record last updated: 5 Jun 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.