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Individual

KATHRYN RAND WACKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
4306 SENECA STREET, WEST SENECA, NY 14224
(716) 675-0155
Mailing address
505 CORTONO DR, RENO, NV 89521-4292
(716) 445-3341

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
047723
NY
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
S3-349C
NV

Other

Enumeration date
10/03/2006
Last updated
07/19/2021
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