Organization
JOHN WIETHOLDER DMD PC
Active
Other names
All American Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN LOUIS WIETHOLDER DMD (DENTIST/OWNER)
(573) 449-1918
Entity
Organization
Contact information
Practice address
601 W NIFONG BLVD, STE 3A, COLUMBIA, MO 65203-6804
(573) 449-1918
(573) 817-3161
Mailing address
601 W NIFONG BLVD, STE 3A, COLUMBIA, MO 65203-6804
(573) 449-1918
(573) 817-3161
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2016009847
MO
Other
Enumeration date
06/07/2016
Last updated
05/02/2017
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