Provider Demographics
NPI:1861498164
Name:WINTERSTEEN, WILLIAM JACOB (DMD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JACOB
Last Name:WINTERSTEEN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23922 CINCO VILLAGE CTR BLVD
Mailing Address - Street 2:STE 111
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-6619
Mailing Address - Country:US
Mailing Address - Phone:281-392-1130
Mailing Address - Fax:
Practice Address - Street 1:23922 CINCO VILLAGE CTR BLVD
Practice Address - Street 2:STE 111
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-6619
Practice Address - Country:US
Practice Address - Phone:281-392-1130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX132911223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery