Individual
JANE LEA WACHTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
102 W SENECA ST, RAVENNA, NE 68869-1363
(308) 452-3523
Mailing address
102 W SENECA ST, PO BOX 68, RAVENNA, NE 68869-1363
(308) 452-3523
(308) 452-3846
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
08906
IA
122300000X
Dentist
Primary
7198
NE
Other
Enumeration date
05/14/2012
Last updated
08/20/2015
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