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General NPI Number Information
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NPI Number | 1033427273
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Entity Type | Organization
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Legal Business Name | LARRY F WHEELER, DDS, PC
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Dates
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Enumeration Date | 09/22/2010
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Last Update Date | 01/26/2011
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Provider Practice Location Address
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Address Line | 5639 E 5TH ST STE E
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City | TUCSON
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State | AZ
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Zip | 85711-2443
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Country | US
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Telephone | 520-745-0030
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Fax |
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Provider Business Mailing Address
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Address Line | 5639 E 5TH ST STE E
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City | TUCSON
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State | AZ
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Zip | 85711-2443
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Country | US
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Telephone | 520-745-0030
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | LARRY F WHEELER
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Credential | DDS
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Telephone | 520-745-0030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D01138
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License Number State | AZ
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