Individual
DR. JOSEPH LAWRENCE WITTIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2013010344
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1932123445
—
MO
01
—
C16000043
MEDICARE - PTAN
MO
Enumeration date
07/27/2006
Last updated
10/12/2016
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