Provider Demographics
NPI:1306040753
Name:SMITH, WILLIAM PRYOR JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:PRYOR
Last Name:SMITH
Suffix:JR
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 1:1785 W SR 89A
Mailing Address - Street 2:SUITE 2D
Mailing Address - City:SEDONA
Mailing Address - State:AZ
Mailing Address - Zip Code:86336-5567
Mailing Address - Country:US
Mailing Address - Phone:928-282-2077
Mailing Address - Fax:
Practice Address - Street 1:1785 W SR 89A
Practice Address - Street 2:SUITE 3-G
Practice Address - City:SEDONA
Practice Address - State:AZ
Practice Address - Zip Code:86336-5567
Practice Address - Country:US
Practice Address - Phone:928-282-2077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7191122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist