Individual
DOMINIC STEVE WENZELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
5855 W UTOPIA RD, GLENDALE, AZ 85308-5251
(623) 537-6000
(623) 806-7010
Mailing address
PO BOX 640, GIRDWOOD, AK 99587-0640
(907) 230-1940
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
AK1116
AK
1223G0001X
General Practice Dentistry
D8309
OR
1223G0001X
General Practice Dentistry
DE00009679
WA
1223G0001X
General Practice Dentistry
Primary
DO11576
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1533613
UNITED CONCORDIA ID NUM.
AK
05
—
DD54213
—
AK
Enumeration date
11/01/2006
Last updated
10/12/2022
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