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Theron Waisath, DMD
Oral & Maxillofacial Surgery (D.M.D.) in Champaign, Illinois
NPI 1144423963

Theron Waisath is a Oral & Maxillofacial Surgery (D.M.D.) based in Champaign, IL. Theron Waisath practices in Champaign, IL and has the professional credentials of DMD. The NPI Number for Theron Waisath is 1144423963 and holds a License No. 019.027879 (Illinois).

The current practice location address for Theron Waisath is 3112 Village Office Pl, Champaign, IL and can be reached out via phone at 217-351-7111 and via fax at 217-351-7282.

Location: 3112 Village Office Pl, Champaign, IL, 61822-7680
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1144423963
Provider Name
Theron Waisath
Credential
DMD
Provider Entity Type
Individual
Gender
Male
Address
3112 Village Office Pl, Champaign, IL, 61822-7680
Phone Number
217-351-7111
Fax Number
217-351-7282
Provider Enumeration Date
06/08/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
3112 Village Office Pl
City
Champaign
State
Illinois
Zip
61822-7680
Phone Number
217-351-7111
Fax Number
217-351-7282
person
Provider Business Mailing Address Details
Address
3112 Village Office Pl
City
Champaign
State
Illinois
Zip
61822-7680
Phone Number
217-351-7111
Fax Number
217-351-7282
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Oral and Maxillofacial Surgery
Taxonomy
1223S0112X
License No.
2422 (Ohio)
Definition
The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
Oral & Maxillofacial Surgery
Speciality
-
Taxonomy
204E00000X
License No.
019.027879 (Illinois)
Definition
Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery.
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