Individual
DAVID CALVIN WENTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
320 2ND AVE S, SUITE 106, MOORHEAD, MN 56560-2602
(218) 236-1666
(218) 236-0543
Mailing address
320 2ND AVE S, SUITE 106, MOORHEAD, MN 56560-2602
(218) 236-1666
(219) 236-0543
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8274
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
411388621
TAX IDENTFICATION NUMBER
MN
Enumeration date
03/22/2007
Last updated
07/08/2007
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