Provider Demographics
NPI:1124196225
Name:GRASS, WILLIAM (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:GRASS
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 1:6 EXECUTIVE PARK DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-5601
Mailing Address - Country:US
Mailing Address - Phone:518-348-0240
Mailing Address - Fax:518-348-0248
Practice Address - Street 1:31 HALL DR # B
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-2751
Practice Address - Country:US
Practice Address - Phone:413-253-9505
Practice Address - Fax:413-256-3188
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA148211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice