Provider Demographics
NPI:1538482732
Name:MONTE A. WHEELER D.D.S. P.A.
Entity Type:Organization
Organization Name:MONTE A. WHEELER D.D.S. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MONTE
Authorized Official - Middle Name:A
Authorized Official - Last Name:WHEELER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:479-756-9996
Mailing Address - Street 1:7247 BROOKLYN AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72762-0886
Mailing Address - Country:US
Mailing Address - Phone:479-756-9996
Mailing Address - Fax:479-756-0050
Practice Address - Street 1:7247 BROOKLYN AVE
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-0886
Practice Address - Country:US
Practice Address - Phone:479-756-9996
Practice Address - Fax:479-756-0050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-02
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR3115261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental