Provider Demographics
NPI:1174685788
Name:MOTT, WILLIAM J (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:J
Last Name:MOTT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:MRS
Other - First Name:LINDA
Other - Middle Name:D
Other - Last Name:MOTT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NONE
Mailing Address - Street 1:1 FIRESTONE DR.
Mailing Address - Street 2:
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374
Mailing Address - Country:US
Mailing Address - Phone:910-235-0837
Mailing Address - Fax:910-235-9235
Practice Address - Street 1:1 FIRESTONE DR.
Practice Address - Street 2:
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374
Practice Address - Country:US
Practice Address - Phone:910-235-0836
Practice Address - Fax:910-235-9235
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA191251223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics