Individual
DR. TIMOTHY MICHAEL WAHL
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
190 S SYKES CREEK PKWY, STE 2, MERRITT ISLAND, FL 32952-3572
(321) 459-0154
(321) 459-0739
Mailing address
190 S SYKES CREEK PKWY, STE 2, MERRITT ISLAND, FL 32952-3572
(321) 459-0154
(321) 459-0739
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DN9499
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DN9499
STATE DENTAL LICENSE
FL
Enumeration date
06/16/2005
Last updated
07/08/2007
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