NPI 1073685152

Russell Conwell Wismer, DDS

Practitioner General Practice Dentistry Shawnee, KS

Practice location

Address: 6301 Pflumm Rd, Shawnee, KS 66216-2468
Phone: (913) 268-7770

Registered specialties

General Practice Dentistry Primary

Dental Providers Taxonomy 1223G0001X Licence KS5745 (KS)

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Registry record

NPI: 1073685152
Entity type: Individual
Sex (as registered): Male
NPI issued: 14 Nov 2006
Record last updated: 8 Jul 2007

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.