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General NPI Number Information
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NPI Number | 1134564537
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Entity Type | Organization
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Legal Business Name | ALBERT J. WESLEY, DDS PC
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Dates
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Enumeration Date | 04/30/2013
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Last Update Date | 08/20/2019
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Provider Practice Location Address
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Address Line | 3753 ORION ROAD
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City | OAKLAND
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State | MI
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Zip | 48363
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Country | US
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Telephone | 248-720-5358
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Fax |
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Provider Business Mailing Address
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Address Line | 3753 ORION RD
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City | OAKLAND
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State | MI
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Zip | 48363-3032
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Country | US
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Telephone | 248-672-8118
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ALBERT WESLEY
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Credential |
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Telephone | 248-270-5358
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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 | 2901015295
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 261QS0112X
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Taxonomy Name | Oral and Maxillofacial Surgery Clinic/Center
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License Number |
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License Number State |
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