Search › Wisconsin › 1223S0112X
Trystan Wiedow, DDS
NPI 1427639038 · on the registry since 2021
Practice
- Address
- 2353 S Ridge Rd
Green Bay, WI 54304 - Phone
- (920) 499-0471
- Organisation at this address
- Bay Oral Surgery & Implant Center, Ltd
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 9
Registry record
- Primary taxonomy
- 1223S0112X
1223S0112X
- Also registered as
- 390200000X
390200000X - Licence states on file
- WI, IA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2026-06-20
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Wisconsin