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NPI Code Detail

MEDICARE: DR. ANDREW BRENT WURTZ DDS

MEDICARE:  DR. ANDREW BRENT WURTZ  DDS
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
11223G0001XGeneral Practice Dentistry7358WA

General Provider Information

NPI Number : 1609996693
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANDREW BRENT WURTZ DDS
Provider Business Mailing Address
First Line : 7317 E CHATTAROY RD
Second Line :
City : CHATTAROY
State : WA
Zip : 99003-8713
Country : US
Telephone Number : 509-238-1565
Fax Number : 509-466-6615
Provider Business Practice Location Address
First Line : 101 W CASCADE WAY STE 205
Second Line :
City : SPOKANE
State : WA
Zip : 99208-6000
Country : US
Telephone Number : 509-466-2595
Fax Number : 509-466-6615
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2007
Last Update Date : 11/20/2012

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Directions to “ DR. ANDREW BRENT WURTZ DDS” Practice Location

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