Provider Demographics
NPI:1811991672
Name:WOEHRLE, RICHARD R (DDS)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:R
Last Name:WOEHRLE
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 1:809 TRAILCREST
Mailing Address - Street 2:
Mailing Address - City:HARKER HEIGHTS
Mailing Address - State:TX
Mailing Address - Zip Code:76548
Mailing Address - Country:US
Mailing Address - Phone:254-698-6252
Mailing Address - Fax:
Practice Address - Street 1:3106 S W S YOUNG DR
Practice Address - Street 2:STE A101
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-2007
Practice Address - Country:US
Practice Address - Phone:254-526-8666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX170561223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
01436624OtherUNITED CONCORDIA