Provider Demographics
NPI:1194853598
Name:DAPPER, WILLIAM ROBERT (DDS MAGD FICOI)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ROBERT
Last Name:DAPPER
Suffix:
Gender:M
Credentials:DDS MAGD FICOI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 W. EL PORTAL
Mailing Address - Street 2:
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92672
Mailing Address - Country:US
Mailing Address - Phone:949-492-1984
Mailing Address - Fax:949-492-1874
Practice Address - Street 1:128 W EL PORTAL
Practice Address - Street 2:
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92672-4632
Practice Address - Country:US
Practice Address - Phone:949-492-1984
Practice Address - Fax:949-492-1874
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0035661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice