Provider Demographics
NPI:1447383203
Name:WHEELER, ROBERT LEONARD III (DDS MS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:LEONARD
Last Name:WHEELER
Suffix:III
Gender:M
Credentials:DDS MS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1300 IROQUOIS AVE
Mailing Address - Street 2:STE 130
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-8553
Mailing Address - Country:US
Mailing Address - Phone:630-717-1606
Mailing Address - Fax:630-717-9702
Practice Address - Street 1:1300 IROQUOIS AVE
Practice Address - Street 2:STE 130
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-8553
Practice Address - Country:US
Practice Address - Phone:630-717-1606
Practice Address - Fax:630-717-9702
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice