John Wietholder, DMD

NPI 1992091862 · on the registry since 2011

Practice

Address: 2441 21st St
U S Army Dental Activity
Fort Campbell, KY 42223
Phone: (270) 798-8614
Fax: (270) 798-8633
Clinicians at this address: 50

Additional practice sites

4004 Peach Ct Ste A, Columbia, MO

Registry record

Primary taxonomy: 122300000X
122300000X
Also registered as: 122300000X
122300000X
Licence states on file: IL, TN, MO
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2021-05-25

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Kentucky