Provider Demographics
NPI:1922069558
Name:STEWART, W.D. JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:W.D.
Middle Name:
Last Name:STEWART
Suffix:JR
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 554
Mailing Address - Street 2:
Mailing Address - City:WYNNE
Mailing Address - State:AR
Mailing Address - Zip Code:72396-0554
Mailing Address - Country:US
Mailing Address - Phone:870-238-2600
Mailing Address - Fax:870-238-5522
Practice Address - Street 1:620 JULIA AVE E
Practice Address - Street 2:
Practice Address - City:WYNNE
Practice Address - State:AR
Practice Address - Zip Code:72396-3504
Practice Address - Country:US
Practice Address - Phone:870-238-2600
Practice Address - Fax:870-238-5522
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR7105419231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice