Dr. Wrthwrt Wrthwrth
ID #139
🏥 Practice Information
Practice Name:
Ljhjlk
Doctor Name:
Dr. Wrthwrt Wrthwrth
Phone:
111-111-1111
Email:
david100@matchmydentist.com
Address:
Jklhlkh 30310
Zipcode:
30310
Joined Platform:
06/12/2025
📊 Performance Metrics
Total Matches:
0 patients
Completed Appts:
0
Patient No-Shows:
0
Patients Refused:
0
Cancelled by Pt:
0
Total Earnings:
$0.00 (0 × $399)
Account Status:
❌ Inactive
📋 Detailed Information
Recent Patient Matches
Original Questionnaire Responses
Q: Office Email
A: afadlskjfhl@efger.com

Q: Practice Name
A: ljhjlk

Q: Address
A: jklhlkh

Q: City
A: lkjhjlk

Q: State
A: lkjhlk

Q: Zip Code
A: 30310

Q: Office Phone
A: 34y4563456y

Q: First Name
A: wrthwrt

Q: Last Name
A: wrthwrth

Q: Degree
A: DDS

Q: Area of Practice
A: General Dentist

Q: Experience
A: 5-10 years

Q: Languages Spoken
A: Spanish

Q: How many new patients are you looking for monthly?
A: 1-5 new patients

Q: Ready to Start Receiving Matches?
A: Yes, I want to start as soon as my profile is approved

Q: URL
A: https://sdtghstr.com

Q: Has your license to practice in this state or any other state been denied, restricted, limited, suspended or revoked; have you ever been reprimanded by a state licensing agency; or are any of these actions pending with respect to your license?
A: No

Q: Has your DEA Registration ever been restricted, limited, suspended or revoked, or are any of these actions pending with respect to your DEA Registration?
A: No

Q: Have any professional liability judgments been entered against you, including arbitration awards or are there professional liability suits currently pending against you?
A: No

Q: Have any professional claim settlements, not involving litigation or arbitration, been paid by you or paid on your behalf?
A: No

Q: Do you now have or have you had a chemical dependency/substance abuse problem?
A: No

Q: If you answered "Yes" to any of the questions above, please provide a detailed explanation, including the outcome. If you prefer to submit supporting documentation, you may email it to credentials@matchmydentist.com.
A: wergewrgterg

Q: Malpractice Document
A: View Document

Q: DEA Certificate
A: View Document

Q: State Dental License
A: View Document

Q: Only the doctor may complete and certify this form. Are you the doctor personally completing this form?
A: Yes

Q: By clicking "I accept" below, you agree to the above certification terms and conditions and consent to electronic signature
A: Yes

Q: Please type your full legal name as your electronic signature.
A: qergqergq

Payment History
Doctor Timeline
Date Joined:
06/12/2025
Complaints/Notes
📝 Admin Notes