Provider Demographics
NPI:1871519033
Name:WOHRLE, PETER S (DMD, MMED SC)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:S
Last Name:WOHRLE
Suffix:
Gender:M
Credentials:DMD, MMED SC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 SAN MIGUEL DR
Mailing Address - Street 2:# 601
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-7853
Mailing Address - Country:US
Mailing Address - Phone:949-720-8072
Mailing Address - Fax:949-720-8073
Practice Address - Street 1:360 SAN MIGUEL DR
Practice Address - Street 2:# 601
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-7853
Practice Address - Country:US
Practice Address - Phone:949-720-8072
Practice Address - Fax:949-720-8073
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA394981223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery