| Douglas A. Witte, Dds, Ms, Inc. | |
|
1029 E Idel St Tyler TX 75701-2025 | |
| (903) 593-9777 | |
| (903) 593-4110 |
| Full Name | Douglas A. Witte, Dds, Ms, Inc. |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 1029 E Idel St, Tyler, Texas |
| Authorized Official Name and Position | Douglas Allen Witte (PRESIDENT) |
| Authorized Official Contact | 9035939777 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Douglas A. Witte, Dds, Ms, Inc. 1029 E Idel St Tyler TX 75701-2025 Ph: (903) 593-9777 | Douglas A. Witte, Dds, Ms, Inc. 1029 E Idel St Tyler TX 75701-2025 Ph: (903) 593-9777 |
| NPI Number | 1497809099 |
|---|---|
| Provider Enumeration Date | 01/22/2007 |
| Last Update Date | 01/21/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497809099 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | 9413 (Texas) | Primary |
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