Organization
KYLE W. WHEELER, DDS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE W. WHEELER D.D.S. (PRESIDENT)
(434) 385-6398
Entity
Organization
Contact information
Practice address
1084 THOMAS JEFFERSON RD, SUITE 5, FOREST, VA 24551-2298
(434) 385-6398
(434) 385-6847
Mailing address
1084 THOMAS JEFFERSON RD, SUITE 5, FOREST, VA 24551-2298
(434) 385-6398
(434) 385-6847
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
0401005293
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7813562
—
VA
Enumeration date
11/02/2013
Last updated
11/02/2013
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