Individual
MARY CATHERINE WURTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
401 BOGLE ST STE 204, SOMERSET, KY 42503-2850
(606) 802-7891
Mailing address
401 BOGLE ST STE 204, SOMERSET, KY 42503-2850
(606) 802-7891
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
9273
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100244450
—
KY
Enumeration date
03/12/2013
Last updated
04/04/2017
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