Provider Demographics
NPI:1023345808
Name:WIMER, ANGELA MARIE (DMD)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:MARIE
Last Name:WIMER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4810 HORSESHOE PIKE
Mailing Address - Street 2:P.O. BOX 550
Mailing Address - City:HONEY BROOK
Mailing Address - State:PA
Mailing Address - Zip Code:19344-0550
Mailing Address - Country:US
Mailing Address - Phone:610-273-3553
Mailing Address - Fax:610-273-9381
Practice Address - Street 1:4810 HORSESHOE PIKE
Practice Address - Street 2:
Practice Address - City:HONEY BROOK
Practice Address - State:PA
Practice Address - Zip Code:19344-0550
Practice Address - Country:US
Practice Address - Phone:610-273-3553
Practice Address - Fax:610-273-9381
Is Sole Proprietor?:No
Enumeration Date:2009-11-16
Last Update Date:2010-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS038000122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist