Provider Demographics
NPI:1144382854
Name:FRAVEL, WILLIAM K (DMD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:K
Last Name:FRAVEL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 SAND LAKE RD
Mailing Address - Street 2:#116
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32809-7681
Mailing Address - Country:US
Mailing Address - Phone:407-826-9439
Mailing Address - Fax:
Practice Address - Street 1:1650 SAND LAKE RD
Practice Address - Street 2:#116
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-7681
Practice Address - Country:US
Practice Address - Phone:407-826-9439
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL88721223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics