Provider Demographics
NPI:1326061821
Name:MACDONNELL, WILLIAM ANDREW (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ANDREW
Last Name:MACDONNELL
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 1:158 HUNTER DR
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06107-1017
Mailing Address - Country:US
Mailing Address - Phone:860-561-1233
Mailing Address - Fax:860-521-4564
Practice Address - Street 1:158 HUNTER DR
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107-1017
Practice Address - Country:US
Practice Address - Phone:860-561-1233
Practice Address - Fax:860-521-4564
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTCT54061223D0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0004XDental ProvidersDentistDentist Anesthesiologist