JERALD D WIENKE

KINGMAN, AZ
NPI1912010216
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: AZ  1371)
Enumeration Date2006-08-17
Last Update Date2007-07-08
Business Address
Mr. JERALD D WIENKE DDS
411 GRANDVIEW AVE
KINGMAN, AZ 86401-5745
Phone number: 928-753-6220
Mailing Address
Mr. JERALD D WIENKE DDS
PO BOX 990
KINGMAN, AZ 86402-0990
Phone number: 928-753-6220
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