Individual
LEO WHEAT JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
51 JEFFERSON PKWY, SUITE A AND B, NEWNAN, GA 30263-5813
(770) 252-9345
(770) 252-9347
Mailing address
51 JEFFERSON PKWY, SUITE A AND B, NEWNAN, GA 30263-5813
(770) 252-9345
(770) 252-9347
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN011271
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000691204A
—
GA
05
—
000691204B
—
GA
Enumeration date
08/15/2006
Last updated
10/08/2007
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