Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | DH072022 | PA |
NPI | 1063089639 |
---|---|
Provider Name | Tammie L Wencil |
First Address | Oil City, PA 16301-5277 |
Second Address | Oil City, PA 16301-1443 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2021 |
Last Update Date | 10/06/2021 |