Individual
DR. MARY HALVERSON WETTACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S., M.S.
Contact information
Practice address
500 S. GRAND AVE, MOUNT PLEASANT, IA 52641-2600
(319) 385-6750
Mailing address
500 S. GRAND AVE, MOUNT PLEASANT, IA 52641-2600
(319) 385-6750
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6739
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0187690
—
IA
01
—
187690
DELTA DENTAL
IA
Enumeration date
01/15/2007
Last updated
09/27/2022
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