Dr. Stephen C. Waller, DDS, LLC

General Practice Dentistry · Ellington, MO

Organization Active NPI

NPI number 1992984173

Practice location

115 Walnut St
Ellington, MO 63638
Phone
(573) 756-4344
Fax
(573) 756-4699

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NPI record

NPI
1992984173
Entity type
Organization (Type 2)
Enumeration date
October 24, 2007
Last updated
January 22, 2009
Organization subpart
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Dentistry Primary 1223G0001X 1999135982 MO

Mailing address

PO Box 157
110 S. 2ND St
Ellington, MO 63638-0157
Phone
(573) 663-2313
Fax
(573) 663-2322

Authorized official

Name
Dr. Stephen C. Waller, D.D.S.
Title
Dentist
Phone
(573) 756-4344

About Dr. Stephen C. Waller, DDS, LLC

Dr. Stephen C. Waller, DDS, LLC is a healthcare organization registered in the NPI registry with the primary taxonomy General Practice Dentistry (code 1223G0001X). The practice location is 115 Walnut St, Ellington, MO 63638. The NPI number 1992984173 was assigned on October 24, 2007 and the record was last updated on January 22, 2009.

Dr. Stephen C. Waller, DDS, LLC lists a license in the registry: #1999135982 (MO) for General Practice Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

The authorized official for this organization is Dr. Stephen C. Waller, D.D.S., Dentist.

Frequently asked questions

What is the NPI number of Dr. Stephen C. Waller, DDS, LLC?

The NPI number is 1992984173.

What is the phone number of Dr. Stephen C. Waller, DDS, LLC?

The phone number listed for the practice location is (573) 756-4344.

Where is Dr. Stephen C. Waller, DDS, LLC located?

115 Walnut St, Ellington, MO 63638.

What is the taxonomy code for Dr. Stephen C. Waller, DDS, LLC?

The primary taxonomy code is 1223G0001X – General Practice Dentistry.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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