Provider Demographics
NPI:1003948027
Name:ARTHUR WESTPHAL DMD AND BRUCE STOLLE DMD PC
Entity Type:Organization
Organization Name:ARTHUR WESTPHAL DMD AND BRUCE STOLLE DMD PC
Other - Org Name:HAWTHORN DENTAL - ST. CHARLES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:STOLLE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:636-928-8400
Mailing Address - Street 1:2300 S OLD HIGHWAY 94
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63303-5622
Mailing Address - Country:US
Mailing Address - Phone:636-928-8400
Mailing Address - Fax:636-928-0480
Practice Address - Street 1:2300 S OLD HIGHWAY 94
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63303-5622
Practice Address - Country:US
Practice Address - Phone:636-928-8400
Practice Address - Fax:636-928-0480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty