Provider Demographics
NPI:1457492373
Name:WIMMER, HOWARD ALAN I (DDS)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:ALAN
Last Name:WIMMER
Suffix:I
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:546 MANAYUNK RD
Mailing Address - Street 2:
Mailing Address - City:MERION STATION
Mailing Address - State:PA
Mailing Address - Zip Code:19066-1137
Mailing Address - Country:US
Mailing Address - Phone:610-664-0328
Mailing Address - Fax:
Practice Address - Street 1:1439 WYOMING AVE
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18509-2329
Practice Address - Country:US
Practice Address - Phone:570-343-7997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS211851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice