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Organization
SOH OF ARKANSAS WILLIAM WELLFORD PORTER PC
Active
Organization
SOH OF ARKANSAS WILLIAM WELLFORD PORTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAYMOND WEBER (REGIONAL SUPPORT SPECIALIST)
(314) 753-8154
Entity
Organization
Contact information
Practice address
2868 W MARTIN LUTHER KING BLVD, FAYETTEVILLE, AR 72704-7625
(479) 249-8181
Mailing address
1422 ELBRIDGE PAYNE RD STE 240, CHESTERFIELD, MO 63017-8544
(314) 753-8154
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
03/30/2018
Last updated
03/30/2018
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