Individual
DR. IRA P WECHTERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
BLDG 6 3237 ROUTE 112, SUITE 7B, MEDFORD, NY 11763-1424
(631) 698-1140
(631) 696-3520
Mailing address
BLDG 6 3237 ROUTE 112, SUITE 7B, MEDFORD, NY 11763-1424
(631) 698-1140
(631) 696-3520
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
26685
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00646960
—
NY
Enumeration date
08/25/2006
Last updated
07/09/2007
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