Provider Demographics
NPI:1720555477
Name:SEEFELDT, WANDA LEE (RDH)
Entity Type:Individual
Prefix:
First Name:WANDA
Middle Name:LEE
Last Name:SEEFELDT
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:WANDA
Other - Middle Name:
Other - Last Name:RINDFLEISCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1810 NORTH 2ND STREET
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54403
Mailing Address - Country:US
Mailing Address - Phone:715-848-4884
Mailing Address - Fax:
Practice Address - Street 1:1810 NORTH 2ND STREET
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54403
Practice Address - Country:US
Practice Address - Phone:715-848-4884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-31
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI9928-16124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist