Provider Demographics
NPI:1417959792
Name:DENNIS, WILLIAM R (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:R
Last Name:DENNIS
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 1:622 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01545-5639
Mailing Address - Country:US
Mailing Address - Phone:508-845-1156
Mailing Address - Fax:
Practice Address - Street 1:622 MAIN ST
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:MA
Practice Address - Zip Code:01545-5639
Practice Address - Country:US
Practice Address - Phone:508-845-1156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA119011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice