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Individual

ROBERT THOMAS WHEATLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1360 S 5TH ST STE 270, SAINT CHARLES, MO 63301
(636) 940-2543
(636) 947-6080
Mailing address
1360 S 5TH ST STE 270, SAINT CHARLES, MO 63301-2446
(636) 940-2543
(636) 947-6080

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
019022027
IL
1223G0001X
General Practice Dentistry
014347
MO
1223G0001X
General Practice Dentistry
Primary
019022027
IL
332B00000X
Durable Medical Equipment & Medical Supplies
014347
MO

Other

Enumeration date
12/11/2006
Last updated
07/21/2022
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