Provider Demographics
NPI:1427284835
Name:WEHRMEISTER, ADAM THOMAS (DDS)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:THOMAS
Last Name:WEHRMEISTER
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 1:133 BAXTER SHOPS
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:MO
Mailing Address - Zip Code:63011-3800
Mailing Address - Country:US
Mailing Address - Phone:636-227-9666
Mailing Address - Fax:636-227-1159
Practice Address - Street 1:133 BAXTER SHOPS
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:MO
Practice Address - Zip Code:63011-3800
Practice Address - Country:US
Practice Address - Phone:636-227-9666
Practice Address - Fax:636-227-1159
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-01
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20090129171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice