John Wietholder Dmd PC

NPI #1063861474 in Columbia, Missouri

Provider Information

NPI Number: 1063861474
Entity Type: Organization
Organization Name: John Wietholder Dmd PC
Primary Specialty: Dentist
Enumeration Date: Jun 7, 2016
Last Updated: May 2, 2017

Practice Location

Address: 601 W NIFONG BLVD
Address 2: STE 3A
City: Columbia
State: Missouri
ZIP Code: 65203-6804
Phone: (573) 449-1918

Authorized Official

Name: DR. JOHN LOUIS WIETHOLDER, DMD
Title: DENTIST/OWNER
Phone: (573) 449-1918

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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