# LINDA WEHNER D.M.D. LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Clifty Family Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568761575
- **Authorized official:** RONNIE JAY WEHNER (MANAGING MEMBER/BUSINESS MANAGER)
- **Authorized official phone:** (812) 273-0207

## Contact information

- **Practice address:** 1105 CLIFTY DRIVE, MADISON, IN 47250
- **Practice address phone:** (812) 273-0207
- **Practice address fax:** (812) 273-3366
- **Mailing address:** 1105 CLIFTY DRIVE, MADISON, IN 47250
- **Mailing address phone:** (812) 273-0207
- **Mailing address fax:** (812) 273-3366

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 12009378A | IN | Yes |
| 1223G0001X | General Practice Dentistry | 12010214A | IN | — |
| 1223G0001X | General Practice Dentistry | 12011362A | IN | — |

## Other

- **Enumeration date:** 03/17/2011
- **Last updated:** 03/17/2011