Provider Demographics
NPI:1578724217
Name:WINARICK, WENDY MICHELE (DDS)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:MICHELE
Last Name:WINARICK
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 1:1701 LAKE SUCCESS DR
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76710-2964
Mailing Address - Country:US
Mailing Address - Phone:254-772-1827
Mailing Address - Fax:254-772-9594
Practice Address - Street 1:1701 LAKE SUCCESS DR
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76710-2964
Practice Address - Country:US
Practice Address - Phone:254-772-1827
Practice Address - Fax:254-772-9594
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-24
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20605122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist