Provider Demographics
NPI:1770916017
Name:WEHRLE-DAVIES, STEPHANIE LYNN (DDS)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:LYNN
Last Name:WEHRLE-DAVIES
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 1:1117 W MAIN ST
Mailing Address - Street 2:PO BOX 63
Mailing Address - City:MONONGAHELA
Mailing Address - State:PA
Mailing Address - Zip Code:15063-2827
Mailing Address - Country:US
Mailing Address - Phone:724-258-4710
Mailing Address - Fax:724-258-4190
Practice Address - Street 1:1117 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MONONGAHELA
Practice Address - State:PA
Practice Address - Zip Code:15063-2827
Practice Address - Country:US
Practice Address - Phone:724-258-4710
Practice Address - Fax:724-258-4190
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-09
Last Update Date:2013-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS039649122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist