Tara J Wheeler Dmd LLC
Clinic/Center, Dental in Loxley, AL. Organization (NPI-2).
NPI number1477848596
StatusActive
Last updated in NPPESJun 16, 2011
Details
- NPI
- 1477848596
- Entity type
- Organization (NPI-2)
- Legal business name
- Tara J Wheeler Dmd LLC
- Organization subpart
- No
- Enumeration date
- Jun 16, 2011
- Last updated
- Jun 16, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | 5751 | AL | Yes |
Other names
- Wheeler Family Dental (Doing Business As)
Practice location
2127 N Hickory StSuite D
Loxley, AL 36551-2411
Phone 251-964-2671 · Fax 251-964-2673
Mailing address
520 2nd AvePleasant Grove, AL 35127-1757
Authorized official
Tara J Wheeler
Owner, Dentist
2056160419
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