Individual
DOUGLAS WITTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS MS
Contact information
Practice address
1029 E IDEL ST, TYLER, TX 75701-2025
(903) 593-9777
(903) 593-4110
Mailing address
1029 E IDEL ST, TYLER, TX 75701-2025
(903) 593-9777
(903) 593-4110
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
9413
TX
Other
Enumeration date
09/18/2014
Last updated
09/18/2014
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