Individual
AMANDA J WANTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
401 WEST MAIL STREET, MERRILL, WI 54452
(715) 539-8181
(715) 539-8109
Mailing address
1810 2ND ST, WAUSAU, WI 54403-3492
(715) 848-4884
(715) 845-5385
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
10470016
WI
Other
Enumeration date
11/18/2008
Last updated
11/18/2008
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