Provider Demographics
NPI:1285648774
Name:WESTER, MILLARD WINSTON III (DDS)
Entity Type:Individual
Prefix:DR
First Name:MILLARD
Middle Name:WINSTON
Last Name:WESTER
Suffix:III
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 RUIN CREEK RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:HENDERSON
Mailing Address - State:NC
Mailing Address - Zip Code:27536-5919
Mailing Address - Country:US
Mailing Address - Phone:252-492-1115
Mailing Address - Fax:252-492-8682
Practice Address - Street 1:511 RUIN CREEK RD
Practice Address - Street 2:SUITE 204
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-5919
Practice Address - Country:US
Practice Address - Phone:252-492-1115
Practice Address - Fax:252-492-8682
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4823122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8999147Medicaid