Provider Demographics
NPI:1508903162
Name:WENNER, KAREN (DDS)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:
Last Name:WENNER
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 1:955 S GEORGE ST
Mailing Address - Street 2:UNIT A
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-3799
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:955 S GEORGE ST
Practice Address - Street 2:UNIT A
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-3799
Practice Address - Country:US
Practice Address - Phone:717-848-1635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS023349L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice