Provider Demographics
NPI:1326203761
Name:PEERY, WENDY (RDH)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:PEERY
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:
Other - Last Name:OHLFS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:115 E 6TH ST S
Mailing Address - Street 2:
Mailing Address - City:LADYSMITH
Mailing Address - State:WI
Mailing Address - Zip Code:54848-1910
Mailing Address - Country:US
Mailing Address - Phone:715-532-5252
Mailing Address - Fax:
Practice Address - Street 1:115 E 6TH ST S
Practice Address - Street 2:
Practice Address - City:LADYSMITH
Practice Address - State:WI
Practice Address - Zip Code:54848-1910
Practice Address - Country:US
Practice Address - Phone:715-532-5252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-24
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10409-016124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist