Provider Demographics
NPI:1366676603
Name:SEXTON, WILLIAM MICHAEL (DMD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:MICHAEL
Last Name:SEXTON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 E HIGH ST
Mailing Address - Street 2:
Mailing Address - City:MT STERLING
Mailing Address - State:KY
Mailing Address - Zip Code:40353-1267
Mailing Address - Country:US
Mailing Address - Phone:859-498-6204
Mailing Address - Fax:859-498-6205
Practice Address - Street 1:25 E HIGH ST
Practice Address - Street 2:
Practice Address - City:MT STERLING
Practice Address - State:KY
Practice Address - Zip Code:40353-1267
Practice Address - Country:US
Practice Address - Phone:859-498-6204
Practice Address - Fax:859-498-6205
Is Sole Proprietor?:No
Enumeration Date:2009-05-13
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY8728122300000X, 1223S0112X
KY48554204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No122300000XDental ProvidersDentist
No204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery