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NPI 1235267865

NPI 1235267865 : WALTER KARL WEXEL DDS : VIRGINIA BEACH, VA

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General NPI Number Information
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    NPI Number           |    1235267865
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    Entity Type          |    Individual 
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    Provider Name        |    WALTER KARL WEXEL DDS
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    03/02/2007
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    2140 GREAT NECK SQ 
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    City                 |    VIRGINIA BEACH
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    State                |    VA
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    Zip                  |    23454
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    Country              |    US
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    Telephone            |    757-681-8181
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    Fax                  |    757-257-0256
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Provider Business Mailing Address
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    Address Line         |    2040 THOMAS BISHOP LN 
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    City                 |    VIRGINIA BEACH
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    State                |    VA
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    Zip                  |    23454
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    Country              |    US
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    Telephone            |    757-481-3517
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    Fax                  |    757-257-0256
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1223X0400X
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    Taxonomy Name        |    Orthodontics and Dentofacial Orthopedics Dentistry
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    License Number       |    0401005690
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    License Number State |    VA
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