Individual
CARL IVAN WHEELER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1 SW 8TH AVE, MILTON FREEWATER, OR 97862-1595
(541) 938-7752
(541) 938-3093
Mailing address
1 SW 8TH AVE, MILTON FREEWATER, OR 97862-1595
(541) 938-7752
(541) 938-3093
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D8975
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022868
—
OR
01
—
943096772
TAX ID
—
Enumeration date
08/10/2007
Last updated
10/02/2015
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