| Mark O Waller, DDS | |
|
N63 W23401 Main St, Sussex, WI 53089-0229 | |
| (262) 246-6806 | |
| (262) 246-6892 |
| Full Name | Mark O Waller |
|---|---|
| Gender | Male |
| Speciality | Dentist - General Practice |
| Location | N63 W23401 Main St, Sussex, Wisconsin |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679670046 | NPI | - | NPPES |
| 799832 | Other | UNITED CONCORDIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 3012 (Wisconsin) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mark O Waller, DDS Po Box 229, Sussex, WI 53089-0229 Ph: (262) 246-6806 | Mark O Waller, DDS N63 W23401 Main St, Sussex, WI 53089-0229 Ph: (262) 246-6806 |
Zachary Wehner, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: W248n5233 Executive Dr Unit 100, Sussex, WI 53089 Phone: 262-820-3330 | |
Dr. Megan Sarah Desroches, DDS Dentist Medicare: Medicare Enrolled Practice Location: N64w24050 Main St Suite 200, Sussex, WI 53089 Phone: 262-820-0825 | |
Heidi Ann Daub, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: N63w23401 Main St, Sussex, WI 53089 Phone: 262-246-6806 | |
Dr. Shahmir Akbar Khan, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: W249n5245 Executive Dr Ste 206, Sussex, WI 53089 Phone: 262-246-0100 | |
Dr. Mary Vezzetti, DDS Dentist Medicare: Medicare Enrolled Practice Location: W249n5245 Executive Dr, Suite 206, Sussex, WI 53089 Phone: 262-820-3330 Fax: 262-820-3325 | |
John C Magnusson, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: N63w23524 Silver Spring Dr, Sussex, WI 53089 Phone: 262-246-6486 Fax: 262-246-6791 | |
Dr. Wayne W. Ostdick, D.D.S., M.S. Dentist Medicare: Medicare Enrolled Practice Location: N64w24050 Main St, Suite 200, Sussex, WI 53089 Phone: 262-820-0825 |