Provider Demographics
NPI:1467672246
Name:WINTERHOLLER, WILLIAM B (DDS)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:B
Last Name:WINTERHOLLER
Suffix:
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 1:3737 GRAND AVE
Mailing Address - Street 2:SUITE #8
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-6258
Mailing Address - Country:US
Mailing Address - Phone:406-652-0505
Mailing Address - Fax:406-652-7474
Practice Address - Street 1:3737 GRAND AVE
Practice Address - Street 2:SUITE #8
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-6258
Practice Address - Country:US
Practice Address - Phone:406-652-0505
Practice Address - Fax:406-652-7474
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT22011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0113747Medicaid