Individual
CHARLES BERNARD WENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
250 FULLER ST S, SHAKOPEE, MN 55379-1323
(952) 445-6657
Mailing address
18394 GLENWOOD RD, RICHMOND, MN 56368-8123
(320) 333-1719
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D14635
MN
Other
Enumeration date
07/14/2021
Last updated
07/14/2021
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