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1427706779
DOMINIK BRAYDEN WENGERT
SAN JOSE, CA
NPI
1427706779
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Former Name
DOMINGO ORGANISTA
Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2022-03-15
Last Update Date
2024-01-08
Business Address
Mr. DOMINIK BRAYDEN WENGERT
425 E SANTA CLARA ST
SAN JOSE, CA 95113-1936
Phone number: 669-245-3429
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Mailing Address
Mr. DOMINIK BRAYDEN WENGERT
425 E SANTA CLARA ST
SAN JOSE, CA 95113-1936
Phone number: 669-245-3429
Copy
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