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Individual

MS. TAMMIE LYNN WYRICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DENTAL HYGIENIST

Contact information

Practice address
228 SAINT GEORGE ST, GONZALES, TX 78629-3910
(830) 672-6511
(830) 672-6430
Mailing address
115 S LAUREL AVE, LULING, TX 78648-2624
(830) 672-6511
(830) 672-6430

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
7498
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
7498
REGISTRATION CERTIFICATE
TX
Enumeration date
08/30/2006
Last updated
07/08/2007
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