Individual
DR. MATTHEW THOMAS WENDAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD, MD
Contact information
Practice address
19045 E VALLEY VIEW PKWY, INDEPENDENCE, MO 64055-7030
(800) 566-2079
Mailing address
12 E 54TH TER, KANSAS CITY, MO 64112-2858
(610) 248-5594
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
10313
TN
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2022006316
MO
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
61841
KS
Other
Enumeration date
07/25/2013
Last updated
07/29/2022
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