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General NPI Number Information
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NPI Number | 1427561042
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Entity Type | Organization
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Legal Business Name | MICHAEL WHEATLEY DDS OF SOUTH DAKOTA PC
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Dates
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Enumeration Date | 11/06/2017
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Last Update Date | 11/06/2017
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Provider Practice Location Address
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Address Line | 811 BELFAST ST
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City | YANKTON
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State | SD
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Zip | 57078-3324
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Country | US
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Telephone | 712-258-3636
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Fax |
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Provider Business Mailing Address
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Address Line | 2928 HAMILTON BLVD STE 101
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City | SIOUX CITY
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State | IA
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Zip | 51104-2424
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Country | US
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Telephone | 712-258-3636
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Fax | 712-255-4163
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL WHEATLEY
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Credential | DDS
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Telephone | 406-217-5183
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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