Provider Demographics
NPI:1235227836
Name:WORDEN, WILLIAM JOHN (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JOHN
Last Name:WORDEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5175 E PACIFIC COAST HWY
Mailing Address - Street 2:SUITE#204
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90804-3317
Mailing Address - Country:US
Mailing Address - Phone:562-421-7686
Mailing Address - Fax:562-597-0639
Practice Address - Street 1:5175 E PACIFIC COAST HWY
Practice Address - Street 2:SUITE#204
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90804-3317
Practice Address - Country:US
Practice Address - Phone:562-421-7686
Practice Address - Fax:562-597-0639
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD490261223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry