Provider Demographics
NPI:1164712436
Name:DENT, WILLIAM GREG (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:GREG
Last Name:DENT
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:WILLIAM
Other - Middle Name:GREG
Other - Last Name:DENT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 11
Mailing Address - Street 2:125 DOUGLAS HWY
Mailing Address - City:OCILLA
Mailing Address - State:GA
Mailing Address - Zip Code:31774-0011
Mailing Address - Country:US
Mailing Address - Phone:229-468-3211
Mailing Address - Fax:
Practice Address - Street 1:402 S DAVIS ST
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:GA
Practice Address - Zip Code:31639-2441
Practice Address - Country:US
Practice Address - Phone:229-686-5113
Practice Address - Fax:229-686-6598
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-07
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA14666183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist