Provider Demographics
NPI:1114059268
Name:DEAN, WILLIAM DAVID (DDS PA)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:DAVID
Last Name:DEAN
Suffix:
Gender:M
Credentials:DDS PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 415
Mailing Address - Street 2:
Mailing Address - City:FLOYDADA
Mailing Address - State:TX
Mailing Address - Zip Code:79235-0415
Mailing Address - Country:US
Mailing Address - Phone:806-983-2975
Mailing Address - Fax:806-983-3068
Practice Address - Street 1:901 W CROCKETT ST
Practice Address - Street 2:
Practice Address - City:FLOYDADA
Practice Address - State:TX
Practice Address - Zip Code:79235-3609
Practice Address - Country:US
Practice Address - Phone:806-983-2975
Practice Address - Fax:806-983-3068
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX114121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX11412OtherLICENSE NUMBER
752915791OtherEIN