Individual
DR. JON JAY WENDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
150 GRIFFIN RD STE 1, PORTSMOUTH, NH 03801-7131
(603) 436-2204
(603) 436-4158
Mailing address
150 GRIFFIN RD STE 1, PORTSMOUTH, NH 03801-7131
(603) 436-2204
(603) 436-4158
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
2493
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2493
STATE LICENSE NUMBER
NH
05
—
30005083
—
NH
Enumeration date
12/19/2006
Last updated
07/08/2007
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