Provider Demographics
NPI:1992716062
Name:FINNEGAN, WAYNE ARTHUR (DDS)
Entity type:Individual
Prefix:DR
First Name:WAYNE
Middle Name:ARTHUR
Last Name:FINNEGAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34617 COUNTY 12
Mailing Address - Street 2:
Mailing Address - City:LANESBORO
Mailing Address - State:MN
Mailing Address - Zip Code:55949-8238
Mailing Address - Country:US
Mailing Address - Phone:507-765-5371
Mailing Address - Fax:
Practice Address - Street 1:3507 ROUND LAKE BLVD NW
Practice Address - Street 2:SUITE 700
Practice Address - City:ANOKA
Practice Address - State:MN
Practice Address - Zip Code:55303-5001
Practice Address - Country:US
Practice Address - Phone:763-323-7677
Practice Address - Fax:763-323-7282
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN74171223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics