Organization
JEFFERY B WHEATON DDS MD AND ASSOCIATES LLC
Active
Parent organization
JEFFERY B WHEATON DDS MD AND ASSOC LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
JEFFERY B WHEATON DDS MD AND ASSOC LLC
Authorized official
DR. JEFFERY B WHEATON DDS,MD (OWNER)
(505) 992-1550
Entity
Organization
Contact information
Practice address
490B W ZIA RD, SUITE #3, SANTA FE, NM 87505-7008
(505) 992-1550
Mailing address
490B W. ZIA RD., SUITE #3, SANTA FE, NM 87505
(505) 992-1550
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2052
NM
Other
Enumeration date
03/27/2014
Last updated
03/27/2014
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