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NPI 1811991672

NPI 1811991672 : RICHARD R WOEHRLE DDS : KILLEEN, TX

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General NPI Number Information
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    NPI Number           |    1811991672
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    Entity Type          |    Individual 
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    Provider Name        |    RICHARD R WOEHRLE DDS
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/09/2005
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    3106 S W S YOUNG DR STE A101
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    City                 |    KILLEEN
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    State                |    TX
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    Zip                  |    76542-2007
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    Country              |    US
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    Telephone            |    254-526-8666
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    809 TRAILCREST 
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    City                 |    HARKER HEIGHTS
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    State                |    TX
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    Zip                  |    76548
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    Country              |    US
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    Telephone            |    254-698-6252
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1223X0400X
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    Taxonomy Name        |    Orthodontics and Dentofacial Orthopedics Dentistry
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    License Number       |    17056
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    License Number State |    TX
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