LORA WONDERLY

FORT WAYNE, IN
NPI1013207265
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: IN  12011879A)
Additional Taxonomies1223G0001X Dentist, General Practice
(Licence: OH  30.023620)
Enumeration Date2011-04-08
Last Update Date2016-07-13
Business Address
Dr. LORA WONDERLY DMD
4616 W JEFFERSON BLVD
FORT WAYNE, IN 46804-6826
Phone number: 260-432-8596
Mailing Address
Dr. LORA WONDERLY DMD
4616 W JEFFERSON BLVD
FORT WAYNE, IN 46804-6826
Phone number: 260-432-8596