Provider Demographics
NPI:1366443624
Name:WUTHNOW, LYNN R (DDS)
Entity Type:Individual
Prefix:DR
First Name:LYNN
Middle Name:R
Last Name:WUTHNOW
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1615 E IRON AVE
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-3237
Mailing Address - Country:US
Mailing Address - Phone:785-823-5568
Mailing Address - Fax:
Practice Address - Street 1:1615 E IRON AVE
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-3237
Practice Address - Country:US
Practice Address - Phone:785-823-5568
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS6784122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist