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Individual
MRS. KELSEY ELIZABETH WONDERCHECK
Active
Individual
MRS. KELSEY ELIZABETH WONDERCHECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D1159
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D1159
SOUTH DAKOTA DENTAL LICENSE
SD
Enumeration date
06/27/2017
Last updated
05/26/2020
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