Individual
KRISTINA MARIE WENER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10590 ENDURING FREEDOM DR BLDG P, FORT DRUM, NY 13602-5503
(315) 772-5576
Mailing address
8557 VAN AMBER RD, CASTORLAND, NY 13620-1207
(315) 317-6144
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
020796
NY
Other
Enumeration date
05/02/2022
Last updated
05/02/2022
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