Healthcare Provider Details
I. General information
NPI: 1649397332
Provider Name (Legal Business Name): CHRISTOPHER J WAHLERS D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/26/2007
Last Update Date: 03/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
801 WEST GERMANTOWN PIKE
EAST NORRITON PA
19403
US
IV. Provider business mailing address
PO BOX 347
FAIRVIEW VILLAGE PA
19409
US
V. Phone/Fax
- Phone: 610-539-8425
- Fax: 215-331-9578
- Phone: 610-539-8425
- Fax: 215-331-9578
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | DS036004 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: