Provider Demographics
NPI:1235323049
Name:ELIADES, WILLIAM GEORGE (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:GEORGE
Last Name:ELIADES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4049 167TH ST
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11358-2628
Mailing Address - Country:US
Mailing Address - Phone:718-445-5610
Mailing Address - Fax:718-886-8446
Practice Address - Street 1:4049 167TH ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358-2628
Practice Address - Country:US
Practice Address - Phone:718-445-5610
Practice Address - Fax:718-886-8446
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-05
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0375401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice