Provider Demographics
NPI:1104856699
Name:ROBERTSON, WILLIAM FORREST JR (DDS)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:FORREST
Last Name:ROBERTSON
Suffix:JR
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 1:917 HARPETH VALLEY PLACE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221
Mailing Address - Country:US
Mailing Address - Phone:615-646-5151
Mailing Address - Fax:615-646-5552
Practice Address - Street 1:917 HARPETH VALLEY PLACE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37221
Practice Address - Country:US
Practice Address - Phone:615-646-5151
Practice Address - Fax:615-646-5552
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS3240122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist