Provider Demographics
NPI:1003964404
Name:CARYL, JR., WILLIAM R (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:R
Last Name:CARYL, JR.
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5102 W GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:CAMILLUS
Mailing Address - State:NY
Mailing Address - Zip Code:13031-2327
Mailing Address - Country:US
Mailing Address - Phone:315-487-0744
Mailing Address - Fax:315-487-5168
Practice Address - Street 1:5102 W GENESEE ST
Practice Address - Street 2:
Practice Address - City:CAMILLUS
Practice Address - State:NY
Practice Address - Zip Code:13031-2327
Practice Address - Country:US
Practice Address - Phone:315-487-0744
Practice Address - Fax:315-487-5168
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY347151223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics