NPI 1063861474

John Wietholder DMD PC

Organisation Dentist Columbia, MO

Practice location

Address: 601 W Nifong Blvd STE 3a, Columbia, MO 65203-6804
Phone: (573) 449-1918
Fax: (573) 817-3161

Authorised official

Name: John Louis Wietholder
Title: Dentist/Owner
Phone: (573) 449-1918

Registered specialties

Dentist Primary

Dental Providers Taxonomy 122300000X Licence 2016009847 (MO)

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Registry record

NPI: 1063861474
Entity type: Organization
NPI issued: 7 Jun 2016
Record last updated: 2 May 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.