Provider Demographics
NPI:1306549233
Name:MOSTELLER, WENDY (RDH)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:MOSTELLER
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 OLD COUNTY 5 RD
Mailing Address - Street 2:
Mailing Address - City:SOD
Mailing Address - State:WV
Mailing Address - Zip Code:25564-9000
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1616 13TH AVE STE 200
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-3840
Practice Address - Country:US
Practice Address - Phone:304-691-1247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-22
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist