Individual
MANDY WENGERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
2700 NW STEWART PKWY, ROSEBURG, OR 97471-1281
(541) 677-4326
Mailing address
193 OAK VALLEY LOOP, WINCHESTER, OR 97495-8935
(951) 533-5824
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H6587
OR
Other
Enumeration date
10/29/2015
Last updated
10/29/2015
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