# JEFFREY R. WERT DMD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366332736
- **Authorized official:** KAITLYN HANSEN (REVENUE ASSURANCE SPECIALIST)
- **Authorized official phone:** (360) 710-1851

## Contact information

- **Practice address:** 2796 ROUTE 611, TANNERSVILLE, PA 18372
- **Practice address phone:** (570) 629-1570
- **Mailing address:** PO BOX 485, TANNERSVILLE, PA 18372-0485
- **Mailing address phone:** (570) 629-1570

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 07/08/2025
- **Last updated:** 07/08/2025