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Organization

DOD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. STEPHEN THOMAS WOLPERT DDS (GENERAL DENTIST)
(254) 371-7787
Entity
Organization

Contact information

Practice address
US ARMY DENTAL ACTIVITY, 4431 68TH STREET, FORT HOOD, TX 76544
(254) 287-3105
Mailing address
US ARMY DENTAL ACTIVITY, 4431 68TH STREET, APO, AA 76544

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
06749
IA
261QD0000X
Dental Clinic/Center
Primary
5863
NE

Other

Enumeration date
06/27/2016
Last updated
06/27/2016
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