Individual
DR. WILLARD WILLIAM WENTZ JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
501 RISON ST, STRATFORD MEDICAL PLAZA, DANVILLE, VA 24541-2458
(434) 792-5134
(434) 791-2919
Mailing address
501 RISON ST, STRATFORD MEDICAL PLAZA, DANVILLE, VA 24541-2458
(434) 792-5134
(434) 791-2919
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
0438000171
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050010
ANTHEM ID
VA
01
—
899-9122
NC MEDICAID
NC
Enumeration date
12/22/2005
Last updated
07/08/2007
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