Provider Demographics
NPI:1437599586
Name:LAY, WILLIAM (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:LAY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:WILLIS
Other - Middle Name:
Other - Last Name:LAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:1810 S BOWEN RD
Mailing Address - Street 2:
Mailing Address - City:PANTEGO
Mailing Address - State:TX
Mailing Address - Zip Code:76013-3340
Mailing Address - Country:US
Mailing Address - Phone:214-730-8742
Mailing Address - Fax:682-247-0475
Practice Address - Street 1:1810 S BOWEN RD
Practice Address - Street 2:
Practice Address - City:PANTEGO
Practice Address - State:TX
Practice Address - Zip Code:76013-3340
Practice Address - Country:US
Practice Address - Phone:817-274-1825
Practice Address - Fax:682-247-0475
Is Sole Proprietor?:No
Enumeration Date:2013-07-02
Last Update Date:2022-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36014122300000X
390200000X
PADS039853122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program