Individual
MARISSA WAGEHOFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
176 SKYLINE DR, KERSEY, PA 15846-9146
(814) 486-0909
Mailing address
712 VALLEY DR, EAST ALTON, IL 62024-1318
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS045212
PA
Other
Enumeration date
06/26/2025
Last updated
06/26/2025
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