Individual
DR. JAY B. WETTSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
478 SW 12TH ST, ONTARIO, OR 97914-3202
(541) 889-6666
(541) 889-2904
Mailing address
478 SW 12TH ST, ONTARIO, OR 97914-3202
(541) 889-6666
(541) 889-2904
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D7219
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209473
—
OR
Enumeration date
05/02/2006
Last updated
07/09/2007
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