Provider Demographics
NPI:1164935268
Name:WILLIAM E DWORET DO LLC
Entity Type:Organization
Organization Name:WILLIAM E DWORET DO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:E
Authorized Official - Last Name:DWORET
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:774-316-7290
Mailing Address - Street 1:21 BREWSTER CROSS RD UNIT C
Mailing Address - Street 2:
Mailing Address - City:ORLEANS
Mailing Address - State:MA
Mailing Address - Zip Code:02653-3339
Mailing Address - Country:US
Mailing Address - Phone:774-316-7290
Mailing Address - Fax:774-316-7291
Practice Address - Street 1:21 BREWSTER CROSS RD UNIT C
Practice Address - Street 2:
Practice Address - City:ORLEANS
Practice Address - State:MA
Practice Address - Zip Code:02653-3339
Practice Address - Country:US
Practice Address - Phone:774-316-7290
Practice Address - Fax:774-316-7291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-10
Last Update Date:2017-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care