MEDICARE: HUGH WENGER DDS ASSOCIATES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DS-20593L	PA

General Provider Information

NPI Number	:	1023148699
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUGH WENGER DDS ASSOCIATES

Provider Business Mailing Address
First Line	:	1013 W MAIN ST
Second Line	:	SUITE 6
City	:	MOUNT JOY
State	:	PA
Zip	:	17552-9699
Country	:	US
Telephone Number	:	717-653-8177
Fax Number	:

Provider Business Practice Location Address
First Line	:	1013 W MAIN ST
Second Line	:	SUITE 6
City	:	MOUNT JOY
State	:	PA
Zip	:	17552-9699
Country	:	US
Telephone Number	:	717-653-8177
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. HUGH WENGER
Credential	:	DDS
Telephone Number	:	717-653-8177

Provider Enumeration Date	:	03/06/2007
Last Update Date	:	09/03/2009

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