Organization · Type 2 NPI
Dr. Stephen C. Waller, Dds, LLC
General Practice Dentistry · Ellington, MO
NPI number
1992984173
Active
Practice location
115 Walnut St
Ellington, MO 63638
Fax (573) 756-4699
Mailing address
PO Box 157, 110 S. 2nd St
Ellington, MO 63638-0157
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| General Practice Dentistry Primary | 1223G0001X | 1999135982 (MO) |
General Practice Dentistry: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
About NPI 1992984173
Dr. Stephen C. Waller, Dds, LLC's National Provider Identifier is 1992984173, issued on Oct 24, 2007. The primary taxonomy on file is General Practice Dentistry (1223G0001X), and the practice location is in Ellington, MO. The record was last updated on Jan 22, 2009.