DR. Trystan Richard Wiedow, DDS is a student in an organized health care education training program in La Crosse, WI. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. DR. Trystan Richard Wiedow, DDS NPI is 1427639038. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a male.
The provider's business location address is:
1836 SOUTH AVE
LA CROSSE, WI
ZIP 54601-429
Phone: (608) 782-7300
The NPI 1427639038 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).
The enumeration date for this NPI number is 4/15/2021 and was last updated on 5/24/2022.