Individual
JEFFREY WETTENGEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
703 CARTHAGE ST, SANFORD, NC 27330-4108
(757) 816-8038
Mailing address
703 CARTHAGE ST, SANFORD, NC 27330-4108
(757) 816-8038
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12945
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12945
NC DENTAL BOARD
NC
Enumeration date
04/13/2020
Last updated
09/02/2022
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