Provider Demographics
NPI:1376832782
Name:ROBERT T. WHEELER DDS INC & MARY A. DELSOL DDS INC
Entity Type:Organization
Organization Name:ROBERT T. WHEELER DDS INC & MARY A. DELSOL DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/ORAL SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:MARY
Authorized Official - Middle Name:A
Authorized Official - Last Name:DELSOL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:949-240-2280
Mailing Address - Street 1:32241 CROWN VALLEY PKWY STE 220
Mailing Address - Street 2:
Mailing Address - City:DANA POINT
Mailing Address - State:CA
Mailing Address - Zip Code:92629-3310
Mailing Address - Country:US
Mailing Address - Phone:949-240-2280
Mailing Address - Fax:949-240-2619
Practice Address - Street 1:32241 CROWN VALLEY PKWY STE 220
Practice Address - Street 2:
Practice Address - City:DANA POINT
Practice Address - State:CA
Practice Address - Zip Code:92629-3310
Practice Address - Country:US
Practice Address - Phone:949-240-2280
Practice Address - Fax:949-240-2619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-06
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty