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Individual

DR. JOHN PHILIP WAHLE III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
800 ROSE ST RM D104, UNIVERSITY OF KENTUCKY COLLEGE OF DENTISTRY, LEXINGTON, KY 40536-0297
(859) 323-5655
Mailing address
800 ROSE ST RM D104, UNIVERSITY OF KENTUCKY COLLEGE OF DENTISTRY, LEXINGTON, KY 40536-0297
(859) 323-5655

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
6476
KY
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
6476
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
60064763
KY
Enumeration date
02/26/2007
Last updated
01/20/2015
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