Organization
DR JAY B WETTSTEIN DMD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAMELA WETTSTEIN (OFFICER)
(541) 889-6666
Entity
Organization
Contact information
Practice address
478 SW 12TH ST, ONTARIO, OR 97914
(541) 889-6666
(541) 889-2904
Mailing address
478 SW 12TH ST, ONTARIO, OR 97914
(541) 889-6666
(541) 889-2904
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D7219
OR
122300000X
Dentist
D8990
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209473
—
OR
05
—
804186800
—
ID
Enumeration date
10/26/2007
Last updated
10/26/2007
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