Provider Demographics
NPI:1851529135
Name:WENGER, TTERRENCE LEE (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:TTERRENCE
Middle Name:LEE
Last Name:WENGER
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5825 LANDERBROOK DR STE 224
Mailing Address - Street 2:
Mailing Address - City:MAYFIELD HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44124-6533
Mailing Address - Country:US
Mailing Address - Phone:440-442-0916
Mailing Address - Fax:440-442-0960
Practice Address - Street 1:5825 LANDERBROOK DR STE 224
Practice Address - Street 2:
Practice Address - City:MAYFIELD HTS
Practice Address - State:OH
Practice Address - Zip Code:44124-6533
Practice Address - Country:US
Practice Address - Phone:440-442-0916
Practice Address - Fax:440-442-0960
Is Sole Proprietor?:No
Enumeration Date:2009-06-25
Last Update Date:2009-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH131841223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics