THERON WAISATH, DMD
Dentist - Oral and Maxillofacial Surgery
Active
Individual
NPI: 1144423963
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Dentist - Oral and Maxillofacial Surgery | 1223S0112X | Yes | 019.027879 (IL) |
| Oral & Maxillofacial Surgery | 204E00000X | No | 2422 (OH) |
Frequently Asked Questions
NPI 1144423963 is the National Provider Identifier for THERON WAISATH, DMD, a Dentist - Oral and Maxillofacial Surgery provider located in Champaign, IL. This NPI was enumerated on June 8, 2007.
THERON WAISATH, DMD practices at 3112 VILLAGE OFFICE PL, Champaign, IL 61822.
Quick Facts
- NPI
- 1144423963
- Type
- Individual
- Enumerated
- Jun 8, 2007
- Last Updated
- Jul 23, 2009
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