# DR. MATTHEW THOMAS WENDAHL

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1568804961
- **Gender:** Man
- **Credential:** DMD, MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 10313 | TN | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 2022006316 | MO | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 61841 | KS | — |

## Other

- **Enumeration date:** 07/25/2013
- **Last updated:** 07/29/2022