Provider Demographics
NPI:1013455419
Name:EWALDO WENDLER DDS PLLC
Entity Type:Organization
Organization Name:EWALDO WENDLER DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:EWALDO
Authorized Official - Middle Name:
Authorized Official - Last Name:WENDLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:305-374-2543
Mailing Address - Street 1:1444 BISCAYNE BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33132-1421
Mailing Address - Country:US
Mailing Address - Phone:305-374-2543
Mailing Address - Fax:
Practice Address - Street 1:1444 BISCAYNE BLVD STE 101
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33132-1421
Practice Address - Country:US
Practice Address - Phone:305-374-2543
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RICHARD EPSTEIN,DMD PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-02-06
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN155171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty