Individual
DR. JANICE G WAHL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1061 S WICKHAM RD, WEST MELBOURNE, FL 32904-1652
(321) 724-1400
(321) 722-4442
Mailing address
1061 S WICKHAM RD, WEST MELBOURNE, FL 32904-1652
(321) 724-1400
(321) 722-4442
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN9348
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
593478002
TAX ID
—
Enumeration date
08/31/2006
Last updated
07/08/2007
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