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General NPI Number Information
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NPI Number | 1801504659
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Entity Type | Organization
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Legal Business Name | JON P. WHEELER, DDS, PA
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Dates
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Enumeration Date | 11/10/2022
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Last Update Date | 11/10/2022
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Provider Practice Location Address
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Address Line | 19077 CHAMPION FOREST DR STE A
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City | SPRING
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State | TX
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Zip | 77379-8516
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Country | US
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Telephone | 832-761-7428
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Fax |
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Provider Business Mailing Address
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Address Line | 6707 STERLING RIDGE DR STE F
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City | THE WOODLANDS
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State | TX
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Zip | 77382-2773
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Country | US
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Telephone | 281-681-9880
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Fax |
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Authorized Official
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Title or Position | OWNER/DOCTOR
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Name | JON P WHEELER
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Credential | DDS, PA
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Telephone | 281-681-9880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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