William Gordon Dewert in Bridgeton - General Practice
William Gordon Dewert - NPI 1083759518
William Gordon Dewert is a General Practice in Bridgeton, Missouri. William Gordon Dewert practices all healthcare services and medical treatments related to General Practice. The NPI Number for William Gordon Dewert is 1083759518. The last update date is 2007-07-08.
William Gordon Dewert's current location address is 12758 Boenker Ln, Bridgeton, Missouri. You can contact this provider via phone number 3147393300 and fax number 3147390005. The mailing address for William Gordon Dewert is 12758 Boenker Ln, Bridgeton, Missouri. To know further, please read the information below!
Provider Profile Detail
| Provider Name | William Gordon Dewert |
|---|---|
| Address | 12758 Boenker Ln, Bridgeton, Missouri |
| Phone Number | 3147393300 |
| Fax Number | 3147390005 |
| Sole Proprietor | Y |
| Credentials | D.M.D. |
NPI Number Detail
| NPI Number | 1083759518 |
|---|---|
| Provider Enumeration Date | 2007-02-21 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 12758 Boenker Ln |
|---|---|
| City | Bridgeton |
| State | Missouri (MO) |
| Post Code | 630442436 |
| Phone Number | 3147393300 |
| Fax Number | 3147390005 |
Provider's Primary Taxonomy Detail
| Speciality | General Practice |
|---|---|
| Taxonomy | 1223G0001X |
| Licence No | 12134 |
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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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What is the unique 10-digit identification code assigned to William Gordon Dewert by the Centers for Medicare & Medicaid Services?
The William Gordon Dewert has been issued the NPI (National Provider Identifier) 1083759518, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of William Gordon Dewert?
The William Gordon Dewert is situated at 12758 Boenker Ln, in the city of Bridgeton, state of MO, with the zip code 630442436.
What is the William Gordon Dewert's area of specialization and corresponding taxonomy classification?
The William Gordon Dewert's specialty field is General Practice, and it falls under the taxonomy code 1223G0001X, which categorizes healthcare providers based on their specialties.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1083759518 to William Gordon Dewert?
The Centers for Medicare & Medicaid Services originally issued the 1083759518 to William Gordon Dewert on 2007-02-21.
As of what date were the details related to William Gordon Dewert most recently updated or revised?
The information pertaining to William Gordon Dewert, including its address, specialty, and other relevant details, was last updated or revised on 2007-07-08.