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Dr. Stephen C. Waller, Dds, Llc
General Practice Dentistry in Ellington, Missouri
NPI 1992984173

Dr. Stephen C. Waller, Dds, Llc is a General Practice Dentistry based in Ellington, MO and is specialized in General Practice. Dr. Stephen C. Waller, Dds, Llc practices in Ellington, MO. The NPI Number for Dr. Stephen C. Waller, Dds, Llc is 1992984173 and holds a License No. 1999135982 (Missouri).

The current practice location address for Dr. Stephen C. Waller, Dds, Llc is 115 Walnut St, Ellington, MO and can be reached out via phone at 573-756-4344 and via fax at 573-756-4699.

Location: 115 Walnut St, Ellington, MO, 63638-0157
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1992984173
Provider Name
Dr. Stephen C. Waller, Dds, Llc
Credential
Provider Entity Type
Organization
Address
115 Walnut St, Ellington, MO, 63638-0157
Phone Number
573-756-4344
Fax Number
573-756-4699
Provider Enumeration Date
10/24/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1578574240 01 MO TYPE 1 NPI NUMBER
institution
Provider Business Practice Location Address Details
Address
115 Walnut St
City
Ellington
State
Missouri
Zip
63638
Phone Number
573-756-4344
Fax Number
573-756-4699
person
Provider Business Mailing Address Details
Address
115 Walnut St
City
Ellington
State
Missouri
Zip
63638
Phone Number
573-756-4344
Fax Number
573-756-4699
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
1999135982 (Missouri)
Definition
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.
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