Provider Demographics
NPI:1265524250
Name:MAGDA, WENDY (DMD)
Entity type:Individual
Prefix:DR
First Name:WENDY
Middle Name:
Last Name:MAGDA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:196 N 7TH ST
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-7852
Mailing Address - Country:US
Mailing Address - Phone:610-588-1571
Mailing Address - Fax:610-588-0571
Practice Address - Street 1:3465 NAZARETH RD STE 200
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18045-8359
Practice Address - Country:US
Practice Address - Phone:610-923-0100
Practice Address - Fax:610-923-0115
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2019-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0360921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice