Individual
ADAM JOSHUA FARRELL WANDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MD
Contact information
Practice address
445 MARCH AVE STE B, HEALDSBURG, CA 95448-3383
(650) 714-3694
Mailing address
9961 HERB RD, WINDSOR, CA 95492-9435
(650) 714-3694
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
105937
CA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
105937
CA
Other
Enumeration date
05/23/2017
Last updated
04/02/2024
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