Provider Demographics
NPI:1598467813
Name:EMILY B WHEELER MALTBA DMD PLLC
Entity Type:Organization
Organization Name:EMILY B WHEELER MALTBA DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:BROOKE
Authorized Official - Last Name:WHEELER MALTBA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:828-765-7383
Mailing Address - Street 1:54 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:SPRUCE PINE
Mailing Address - State:NC
Mailing Address - Zip Code:28777-8937
Mailing Address - Country:US
Mailing Address - Phone:828-765-7383
Mailing Address - Fax:
Practice Address - Street 1:54 BROAD ST
Practice Address - Street 2:
Practice Address - City:SPRUCE PINE
Practice Address - State:NC
Practice Address - Zip Code:28777-8937
Practice Address - Country:US
Practice Address - Phone:828-765-7383
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1578184347Medicaid