Provider Demographics
NPI:1467569301
Name:WOEHLING, DONALD H (DDS)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:H
Last Name:WOEHLING
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7117 GREEN BAY RD
Mailing Address - Street 2:
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53142-1450
Mailing Address - Country:US
Mailing Address - Phone:262-942-7000
Mailing Address - Fax:262-942-7117
Practice Address - Street 1:7117 GREEN BAY RD
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53142-1450
Practice Address - Country:US
Practice Address - Phone:262-942-7000
Practice Address - Fax:262-942-7117
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4988-0151223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI33747700Medicaid