Healthcare Provider Details

I. General information

NPI: 1366545998
Provider Name (Legal Business Name): DONALD L WEXLER DDS PH D PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1222 MARINER BLVD
SPRING HILL FL
34609
US

IV. Provider business mailing address

1222 MARINER BLVD
SPRING HILL FL
34609
US

V. Phone/Fax

Practice location:
  • Phone: 352-688-0331
  • Fax: 352-688-6238
Mailing address:
  • Phone: 352-688-0331
  • Fax: 352-688-6238

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDN0014683
License Number StateFL

VIII. Authorized Official

Name: DR. DONALD LEE WEXLER
Title or Position: PRESIDENT
Credential: DDS
Phone: 352-688-0331