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DR. JOHN WURTH SKELLENGER DDS
General Practice >> Dentist >> Dental ProvidersRegistrant NPI Number: 1598852865
Individual Registrant:DR. JOHN WURTH SKELLENGER DDS
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
1103 DELTA AVE GLADSTONE, MI 49837-0167 US
Tel: 906-428-1616 Fax: --
Tel: 906-428-1616 Fax: --
Contact information for business:
P.O. BOX 167 GLADSTONE, MI 49837-0167 US
Tel: 906-428-1616 Fax: --
Tel: 906-428-1616 Fax: --
Registration Information:
NPI: 1598852865
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 1223G0001X | Dental Providers Dentist General Practice | MI | 11634 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 4043740 | MI | 05 |
