Provider Demographics
NPI:1245757426
Name:WILHELM, JOHN CHARLES (DDS)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:CHARLES
Last Name:WILHELM
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:807 CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:LA PLATA
Mailing Address - State:MD
Mailing Address - Zip Code:20646-9501
Mailing Address - Country:US
Mailing Address - Phone:301-934-4625
Mailing Address - Fax:
Practice Address - Street 1:807 CHARLES ST
Practice Address - Street 2:
Practice Address - City:LA PLATA
Practice Address - State:MD
Practice Address - Zip Code:20646-9501
Practice Address - Country:US
Practice Address - Phone:301-934-4625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD3728122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist