Provider Demographics
NPI:1629202049
Name:WITTERS, WILLIAM BRANDON (DDS)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:BRANDON
Last Name:WITTERS
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 1:1649 E STROOP RD
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45429-5037
Mailing Address - Country:US
Mailing Address - Phone:937-436-2210
Mailing Address - Fax:866-433-4535
Practice Address - Street 1:1649 E STROOP RD
Practice Address - Street 2:
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45429-5037
Practice Address - Country:US
Practice Address - Phone:937-436-2210
Practice Address - Fax:866-433-4535
Is Sole Proprietor?:No
Enumeration Date:2009-05-13
Last Update Date:2018-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2809122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist