| NPI | 1972684793 |
|---|---|
| Former Name | PENELOPE LYNN WEHNERT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IN 12009890) |
| Additional Taxonomies | 122300000X Dentist (Licence: IN 12009890) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2023-11-08 |