Basic Information
| Provider Information | |||||||||
| NPI: | 1952387540 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DENNIS | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | |||||||||
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| Credential: | DMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3 WOODSTOWN DR | ||||||||
| Address2: | |||||||||
| City: | FREEHOLD | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 077289502 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7748400613 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 351 PLEASANT LAKE AVE | ||||||||
| Address2: | |||||||||
| City: | HARWICH | ||||||||
| State: | MA | ||||||||
| PostalCode: | 026451813 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5084307710 | ||||||||
| FaxNumber: | 5084301599 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/16/2005 | ||||||||
| LastUpdateDate: | 06/08/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 122300000X | 20521 | MA | N | Dental Providers | Dentist | 122300000X | 22DI012561 | NJ | Y | Dental Providers | Dentist |
No ID Information.