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General NPI Number Information
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NPI Number | 1891900643
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Entity Type | Individual
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Provider Name | DR. KAREN WEDDE
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Gender | Female
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1055 WITZEL AVE
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City | OSHKOSH
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State | WI
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Zip | 54902-5719
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Country | US
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Telephone | 920-235-0448
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Fax | 920-734-1052
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Provider Business Mailing Address
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Address Line | 24 W 16TH AVE
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City | OSHKOSH
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State | WI
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Zip | 54902-6902
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Country | US
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Telephone |
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 2308-015
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License Number State | WI
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