Provider Demographics
NPI:1528193752
Name:KINGERY, WILLIAM H SR (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:H
Last Name:KINGERY
Suffix:SR
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 1:2554 LEWISVILLE CLEMMONS RD
Mailing Address - Street 2:
Mailing Address - City:CLEMMONS
Mailing Address - State:NC
Mailing Address - Zip Code:27012-8110
Mailing Address - Country:US
Mailing Address - Phone:336-766-0511
Mailing Address - Fax:336-766-7390
Practice Address - Street 1:2554 LEWISVILLE CLEMMONS RD
Practice Address - Street 2:
Practice Address - City:CLEMMONS
Practice Address - State:NC
Practice Address - Zip Code:27012-8110
Practice Address - Country:US
Practice Address - Phone:336-766-0511
Practice Address - Fax:336-766-7390
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC34681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice