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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