Individual
DR. JOHN WURTH SKELLENGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1103 DELTA AVE, GLADSTONE, MI 49837-0167
(906) 428-1616
Mailing address
P.O. BOX 167, GLADSTONE, MI 49837-0167
(906) 428-1616
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11634
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4043740
—
MI
Enumeration date
10/06/2006
Last updated
07/08/2007
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