Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
THERON WAISATH, DMD
Active Sole ProprietorTHERON WAISATH, DMD is a Oral & Maxillofacial Surgery healthcare provider located in CHAMPAIGN, Illinois. NPI 1144423963 is currently active in the NPPES registry. Verify at CMS.
Oral & Maxillofacial Surgery · CHAMPAIGN, IL
Registration Details
- NPI Number
- 1144423963
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 8, 2007 (19.197371516563 yrs)
- Last Updated
- Jul 23, 2009
- Licenses
-
019.027879 (IL)2422 (OH)
- Sole Proprietor
- Yes
Practice Information
- Address
-
3112 VILLAGE OFFICE PLCHAMPAIGN, IL, 618227680Browse IL providers · Browse ZIP 61822
- Phone
- 2173517111
- Fax
- 2173517282
- Primary Specialty
-
Oral & Maxillofacial Surgery
1223S0112X
- Additional Specialty
- Oral & Maxillofacial Surgery (Physician)
Other Oral & Maxillofacial Surgery Providers in CHAMPAIGN, IL
| Name | Credential | NPI |
|---|---|---|
| DR. VICTOR ESCOBAR | D.D.S., PH.D. | 1750397501 |
| DR. EUGENE MICHAEL OZMENT | DDS | 1518025394 |
| DR. MARK ANDREW STEPHENS | D.M.D. | 1255652665 |
| NICHOLAS MECHAS | D.M.D. | 1164886362 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.