Jackie N. Wyland

NPI #1841462462 in East Freedom, Pennsylvania

Provider Information

NPI Number: 1841462462
Entity Type: Organization
Organization Name: Jackie N. Wyland
Primary Specialty: Dentist
Enumeration Date: Mar 25, 2008
Last Updated: Jul 31, 2008

Practice Location

Address: RD 1 BOX 147 A
Address 2: DEVECCHIS ST MCKEE
City: East Freedom
State: Pennsylvania
ZIP Code: 16637
Phone: (814) 695-1801

Authorized Official

Name: MR. JACKIE NELSON WYLAND
Title: OWNER
Phone: (814) 695-1801

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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