Provider Demographics
NPI:1437229960
Name:COFER, WILLIAM AUGUSTAS (DMD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:AUGUSTAS
Last Name:COFER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:WILLIAM
Other - Middle Name:AUGUSTAS
Other - Last Name:COFER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:115 COUNTRY VIEW DR
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-4916
Mailing Address - Country:US
Mailing Address - Phone:864-238-4738
Mailing Address - Fax:864-297-1136
Practice Address - Street 1:215 W POINSETT ST
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29650-1945
Practice Address - Country:US
Practice Address - Phone:864-877-1891
Practice Address - Fax:864-877-6652
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC17281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCZ17287Medicaid