Provider Demographics
NPI:1235240268
Name:WESTRBOOK, WILLIAM PARKER (DMD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:PARKER
Last Name:WESTRBOOK
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 N ELLIS ST
Mailing Address - Street 2:
Mailing Address - City:CAMILLA
Mailing Address - State:GA
Mailing Address - Zip Code:31730-1502
Mailing Address - Country:US
Mailing Address - Phone:229-336-0305
Mailing Address - Fax:229-336-0307
Practice Address - Street 1:32 N ELLIS ST
Practice Address - Street 2:
Practice Address - City:CAMILLA
Practice Address - State:GA
Practice Address - Zip Code:31730-1502
Practice Address - Country:US
Practice Address - Phone:229-336-0305
Practice Address - Fax:229-336-0307
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA98411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00270047BMedicaid