NPI 1013207265

Lora Wonderly, DMD

Practitioner General Practice Dentistry Fort Wayne, IN

Practice location

Address: 4616 W Jefferson Blvd, Fort Wayne, IN 46804-6826
Phone: (260) 432-8596

Registered specialties (2)

General Practice Dentistry Primary

Dental Providers Taxonomy 1223G0001X Licence 12011879A (IN)

Other Dentist providers in Indiana →

General Practice Dentistry

Dental Providers Taxonomy 1223G0001X Licence 30.023620 (OH)

Registry record

NPI: 1013207265
Entity type: Individual
Sex (as registered): Female
NPI issued: 8 Apr 2011
Record last updated: 13 Jul 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.