Provider Demographics
NPI:1114138385
Name:STEWART, WILLIAM S (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:S
Last Name:STEWART
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 1:646 WATERSIDE WAY
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34242-1416
Mailing Address - Country:US
Mailing Address - Phone:941-349-0736
Mailing Address - Fax:
Practice Address - Street 1:1215 S EAST AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2342
Practice Address - Country:US
Practice Address - Phone:941-953-2080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL76111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice