Individual
LYNN CHARLES WENTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1265 AHSAHKA RD, OROFINO, ID 83544-9025
(208) 476-4315
(208) 476-4353
Mailing address
PO BOX 748, OROFINO, ID 83544-0748
(208) 476-4315
(208) 476-4353
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D2073
ID
Other
Enumeration date
07/12/2007
Last updated
07/12/2007
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