MEDICARE: DR. ROBERT T. WHEELER JR. D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	D27853	CA

General Provider Information

NPI Number	:	1184663262
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT T. WHEELER JR. D.D.S.

Provider Business Mailing Address
First Line	:	24400 MUIRLANDS BLVD
Second Line	:	SUITE C
City	:	LAKE FOREST
State	:	CA
Zip	:	92630-3946
Country	:	US
Telephone Number	:	949-859-3822
Fax Number	:	949-859-3824

Provider Business Practice Location Address
First Line	:	24400 MUIRLANDS BLVD
Second Line	:	SUITE C
City	:	LAKE FOREST
State	:	CA
Zip	:	92630-3946
Country	:	US
Telephone Number	:	949-859-3822
Fax Number	:	949-859-3824

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2006
Last Update Date	:	11/24/2008

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Directions to “ DR. ROBERT T. WHEELER JR. D.D.S.” Practice Location

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