Individual
DR. MICHAEL JAY WIRTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1029 W 4TH ST, WATERLOO, IA 50702-2803
(319) 235-0361
(319) 235-0362
Mailing address
1029 W 4TH ST, WATERLOO, IA 50702-2803
(319) 235-0361
(319) 235-0362
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
06716
IA
Other
Enumeration date
10/12/2006
Last updated
07/08/2007
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