Individual
DR. BENJAMIN EARL DEWAAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1 SOUTHTOWNE DR, POTOSI, MO 63664-5729
(573) 438-8401
(573) 438-8402
Mailing address
1 SOUTHTOWNE DR, POTOSI, MO 63664-5729
(573) 438-8401
(573) 438-8402
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2011017964
MO
Other
Enumeration date
06/20/2011
Last updated
06/20/2011
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