Provider Demographics
NPI:1750715082
Name:WHEELER, CARL H (DDS,MS)
Entity type:Individual
Prefix:DR
First Name:CARL
Middle Name:H
Last Name:WHEELER
Suffix:
Gender:M
Credentials:DDS,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3915 SUNFOREST CT
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-4453
Mailing Address - Country:US
Mailing Address - Phone:419-473-1339
Mailing Address - Fax:419-434-9010
Practice Address - Street 1:3915 SUNFOREST CT
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-4453
Practice Address - Country:US
Practice Address - Phone:419-473-1339
Practice Address - Fax:419-434-9010
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-22
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH185581223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics