# JEFFERY B WHEATON DDS MD AND ASSOCIATES LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** JEFFERY B WHEATON DDS MD AND ASSOC LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1881011864
- **Legal business name:** JEFFERY B WHEATON DDS MD AND ASSOC LLC
- **Authorized official:** DR. JEFFERY B WHEATON DDS,MD (OWNER)
- **Authorized official phone:** (505) 992-1550

## Contact information

- **Practice address:** 490B W ZIA RD, SUITE \#3, SANTA FE, NM 87505-7008
- **Practice address phone:** (505) 992-1550
- **Mailing address:** 490B W. ZIA RD., SUITE \#3, SANTA FE, NM 87505
- **Mailing address phone:** (505) 992-1550

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 2052 | NM | Yes |

## Other

- **Enumeration date:** 03/27/2014
- **Last updated:** 03/27/2014