Individual
STEPHANIE KAY WENDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
1816 N EASTERN AVE, MOORE, OK 73160-5614
(405) 794-6633
Mailing address
1816 N EASTERN AVE, MOORE, OK 73160-5614
(405) 794-6633
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4897
OK
Other
Enumeration date
07/31/2006
Last updated
07/08/2007
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