Healthcare Provider Details

I. General information

NPI: 1588858955
Provider Name (Legal Business Name): WENDY A NACHREINER RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2007
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIT 26610 BAVARIA DENTAL ACTIVITY CREDENTIALS OFFICE
APO AE
09244
US

IV. Provider business mailing address

UNIT 26610 BAVARIA DENTAL ACTIVITY CREDENTIALS OFFICE
APO AE
09244
US

V. Phone/Fax

Practice location:
  • Phone: 499318043933
  • Fax: 499318042524
Mailing address:
  • Phone: 499318043933
  • Fax: 499318042524

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberH7434
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: