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General NPI Number Information
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NPI Number | 1962923268
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Entity Type | Individual
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Provider Name | BENJAMIN LANIER WHEELER DMD
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Gender | Male
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Dates
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Enumeration Date | 06/28/2017
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 2321 POOLER PKWY STE 112
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City | POOLER
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State | GA
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Zip | 31322-4423
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Country | US
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Telephone | 912-737-4114
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Fax | 912-737-4115
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Provider Business Mailing Address
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Address Line | 2321 POOLER PKWY STE 112
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City | POOLER
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State | GA
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Zip | 31322-4423
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Country | US
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Telephone | 912-737-4114
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Fax | 912-737-4115
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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 | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 015827
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License Number State | GA
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