Provider Demographics
NPI:1659415685
Name:WESTFALL, WAYNE F (DDS)
Entity Type:Individual
Prefix:DR
First Name:WAYNE
Middle Name:F
Last Name:WESTFALL
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:PO BOX 1645
Mailing Address - Street 2:303 MARSHALL RD.
Mailing Address - City:PLATTE CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64079-1645
Mailing Address - Country:US
Mailing Address - Phone:816-858-2300
Mailing Address - Fax:816-858-2460
Practice Address - Street 1:303 MARSHALL RD
Practice Address - Street 2:
Practice Address - City:PLATTE CITY
Practice Address - State:MO
Practice Address - Zip Code:64079-9439
Practice Address - Country:US
Practice Address - Phone:816-858-2300
Practice Address - Fax:816-858-2460
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0127571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice