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Individual

MICHAEL ERNEST WAHL

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
1104 W COLORADO AVE, COLORADO SPRINGS, CO 80904
(719) 633-8766
(719) 635-5259
Mailing address
1104 W COLORADO AVE, COLORADO SPRINGS, CO 80904
(719) 633-8766
(719) 635-5259

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
105967
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02105963
CO
Enumeration date
08/02/2005
Last updated
03/07/2023
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