Provider Demographics
NPI:1508934746
Name:WOEHRLEN, ARTHUR E JR (DDS)
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:E
Last Name:WOEHRLEN
Suffix:JR
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 1:13403 13 MILE ROAD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48088
Mailing Address - Country:US
Mailing Address - Phone:586-979-2800
Mailing Address - Fax:248-979-2720
Practice Address - Street 1:13403 EAST THIRTEEN MILE ROAD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48088
Practice Address - Country:US
Practice Address - Phone:586-979-2800
Practice Address - Fax:586-979-2872
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901010540122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4049959Medicaid
MI4049959Medicaid