Provider Demographics
NPI:1164685780
Name:JOSEPH B WECHSLER DDS A DENTAL CORPORATION
Entity Type:Organization
Organization Name:JOSEPH B WECHSLER DDS A DENTAL CORPORATION
Other - Org Name:LANCASTER DENTAL GROUP
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MITCHELL
Authorized Official - Middle Name:A
Authorized Official - Last Name:WECHSLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:661-945-0929
Mailing Address - Street 1:2059 W AVE K
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93536
Mailing Address - Country:US
Mailing Address - Phone:661-945-0929
Mailing Address - Fax:661-723-2189
Practice Address - Street 1:2059 W AVE K
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93536
Practice Address - Country:US
Practice Address - Phone:661-945-0929
Practice Address - Fax:661-723-2189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-03
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54727122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty