Provider Demographics
NPI:1295824951
Name:HURST, WILLIAM C SR (DMD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:C
Last Name:HURST
Suffix:SR
Gender:M
Credentials:DMD
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Mailing Address - Street 1:6578 HURST LN
Mailing Address - Street 2:
Mailing Address - City:BLACKSHEAR
Mailing Address - State:GA
Mailing Address - Zip Code:31516-1173
Mailing Address - Country:US
Mailing Address - Phone:912-449-1389
Mailing Address - Fax:912-449-4502
Practice Address - Street 1:410 LISTER ST
Practice Address - Street 2:
Practice Address - City:WAYCROSS
Practice Address - State:GA
Practice Address - Zip Code:31501-5226
Practice Address - Country:US
Practice Address - Phone:912-285-1218
Practice Address - Fax:912-285-9518
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA0071911223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry