Wahl, Timothy Michael

Wahl, Timothy Michael is an individual health care provider with primary practice located at 190 S Sykes Creek Pkwy Ste 2, Merritt Island FL 32952-3572. He recently has only one registered license in Dental Providers / Periodontics, which is considered as his primary health care specialty. Wahl, Timothy Michael can be contacted via phone (321) 459-0154.

Contact Information

Primary practice address
190 S Sykes Creek Pkwy Ste 2 Merritt Island FL 32952-3572
Phone: (321) 459-0154
Fax: (321) 459-0739
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Periodontics 1223P0300X DN9499 Florida

Profile Details

NPI number 1619972668
LBN Legal business name Wahl, Timothy Michael
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2005
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619972668 NPPES
Florida Other DN9499 STATE DENTAL LICENSE

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