Provider Demographics
NPI:1013004399
Name:WOODWARD, WILLIAM TERRY (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:TERRY
Last Name:WOODWARD
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 1:2425 UNIVERSITY BLVD W
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32217-2001
Mailing Address - Country:US
Mailing Address - Phone:904-733-7030
Mailing Address - Fax:904-733-7038
Practice Address - Street 1:2425 UNIVERSITY BLVD W
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32217-2001
Practice Address - Country:US
Practice Address - Phone:904-733-7030
Practice Address - Fax:904-733-7038
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL40461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice