Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. JODY LYNN WRATHALL, D.D.S., M.S.
Active Sole ProprietorDR. JODY LYNN WRATHALL, D.D.S., M.S. is a Pediatric Dentistry healthcare provider located in PORTAGE, Michigan. NPI 1306142815 is currently active in the NPPES registry. Verify at CMS.
Pediatric Dentistry · PORTAGE, MI
Registration Details
- NPI Number
- 1306142815
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jan 31, 2011 (15.527244025133 yrs)
- Last Updated
- Mar 17, 2018
- Licenses
-
2901020339 (MI)2901020339 (MI)
- Sole Proprietor
- Yes
Practice Information
- Address
-
3020 OLD CENTRE RDPORTAGE, MI, 49024Browse MI providers · Browse ZIP 49024
- Phone
- 2693288016
- Fax
- 2693238524
- Primary Specialty
-
Pediatric Dentistry
1223P0221X
- Additional Specialty
- Pediatric Dentistry
Other Pediatric Dentistry Providers in PORTAGE, MI
| Name | Credential | NPI |
|---|---|---|
| DR. JOHN H DEPPEN | DDS | 1134117807 |
| JACKIE HWANG | — | 1255822961 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.