Provider Demographics
NPI:1437187127
Name:MORSE, WILLIAM J (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:J
Last Name:MORSE
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 1:2199 A1A S
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32080-6513
Mailing Address - Country:US
Mailing Address - Phone:904-471-3300
Mailing Address - Fax:904-471-5240
Practice Address - Street 1:2199 A1A S
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32080-6513
Practice Address - Country:US
Practice Address - Phone:904-471-3300
Practice Address - Fax:904-471-5240
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL27551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2755OtherLICENSE NO