Provider Demographics
NPI:1720233935
Name:WHEELER, JOHN BAKER IV (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:BAKER
Last Name:WHEELER
Suffix:IV
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:JOHN
Other - Middle Name:BAKER
Other - Last Name:WHEELER
Other - Suffix:IV
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:212 W. MARKET ST.
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19947
Mailing Address - Country:US
Mailing Address - Phone:302-856-7423
Mailing Address - Fax:
Practice Address - Street 1:212 W. MARKET ST.
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:DE
Practice Address - Zip Code:19947
Practice Address - Country:US
Practice Address - Phone:302-856-7423
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-02
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEG1-0000941122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist