All Medicaid billing entities listing WIETECHA, JAY (PROPRIETOR) as their authorized official in the NPPES registry.
| State | Entities | Total Paid |
|---|---|---|
| Maine | 1 | $390.00 |
| # | Provider | Location | Specialty | Total Paid |
|---|---|---|---|---|
| 1 | COSMETIC & GENERAL DENTISTRY OF WINTHROP | WINTHROP, ME | Dental Clinic/Center | $390.00 |