Healthcare Provider Details

I. General information

NPI: 1285180869
Provider Name (Legal Business Name): BARBARA WEGIEL DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2016
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

FORT BRAGG DENTAC
APO AA
28310
US

IV. Provider business mailing address

4076 NEELY RD
FORT BRAGG NC
28310-0001
US

V. Phone/Fax

Practice location:
  • Phone: 910-907-8707
  • Fax:
Mailing address:
  • Phone: 910-907-8707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number019.030736
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number019030736
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: