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NPI Code Detail

MEDICARE: JON PEYTON WHEELER DDS

MEDICARE: JON PEYTON WHEELER DDS
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
11223P0221XPediatric Dentistry19775TX

General Provider Information

NPI Number : 1750502381
Entity Type Code : Individual
Provider Name (Legal Business Name) : JON PEYTON WHEELER DDS
Provider Business Mailing Address
First Line : 6707 STERLING RIDGE DR
Second Line : SUITE F
City : THE WOODLANDS
State : TX
Zip : 77382-2746
Country : US
Telephone Number : 281-681-9880
Fax Number : 281-681-9543
Provider Business Practice Location Address
First Line : 6707 STERLING RIDGE DR
Second Line : SUITE F
City : THE WOODLANDS
State : TX
Zip : 77382-2746
Country : US
Telephone Number : 281-681-9880
Fax Number : 281-681-9543
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2007
Last Update Date : 07/08/2007

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