Provider Demographics
NPI:1093849770
Name:ALFONSO, WILLIAM F (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:F
Last Name:ALFONSO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2501 CRESTWOOD RD
Mailing Address - Street 2:STE. 302
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72116-6864
Mailing Address - Country:US
Mailing Address - Phone:501-771-4631
Mailing Address - Fax:501-771-4682
Practice Address - Street 1:2501 CRESTWOOD RD
Practice Address - Street 2:STE. 302
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72116-6864
Practice Address - Country:US
Practice Address - Phone:501-771-4631
Practice Address - Fax:501-771-4682
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARDS22461223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery