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General NPI Number Information
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NPI Number | 1609059609
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Entity Type | Organization
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Legal Business Name | JAMES M. WENSINK DDS INC.
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Dates
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Enumeration Date | 12/12/2007
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Last Update Date | 12/12/2007
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Provider Practice Location Address
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Address Line | 19551 EUCLID AVE
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City | EUCLID
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State | OH
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Zip | 44117-1409
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Country | US
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Telephone | 216-692-3777
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Fax | 216-692-3688
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Provider Business Mailing Address
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Address Line | 19551 EUCLID AVE
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City | EUCLID
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State | OH
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Zip | 44117-1409
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Country | US
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Telephone | 216-692-3777
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Fax | 216-692-3688
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAMES M. WENSINK
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Credential | D.D.S.
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Telephone | 216-692-3777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 30-014999
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License Number State | OH
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