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General NPI Number Information
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NPI Number | 1174254767
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Entity Type | Individual
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Provider Name | DAVID WERTZ DDS
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Gender | Male
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Dates
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Enumeration Date | 06/23/2022
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Last Update Date | 03/20/2025
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Provider Practice Location Address
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Address Line | 909 WALNUT ST
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City | PHILADELPHIA
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State | PA
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Zip | 19107-5211
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Country | US
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Telephone | 215-955-6215
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Fax |
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Provider Business Mailing Address
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Address Line | 909 WALNUT ST
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City | PHILADELPHIA
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State | PA
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Zip | 19107-5211
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Country | US
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Telephone | 215-955-6215
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 6001112-15
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DS044498
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DN27637
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License Number State | FL
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