Individual
DOUGLAS GUY WENZEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
624 S MERIDIAN, PUYALLUP, WA 98371-5908
(253) 845-3301
(253) 840-1803
Mailing address
624 S MERIDIAN, PUYALLUP, WA 98371-5908
(253) 845-3301
(253) 840-1803
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00005884
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
832312
UNITED CONCORDIA INS
—
Enumeration date
08/29/2006
Last updated
07/08/2007
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