Provider Demographics
NPI:1558698001
Name:WILLIAM S. HARVEY III, DDS PLLC
Entity Type:Organization
Organization Name:WILLIAM S. HARVEY III, DDS PLLC
Other - Org Name:HARVEY AND ASSOCIATES FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:S
Authorized Official - Last Name:HARVEY
Authorized Official - Suffix:III
Authorized Official - Credentials:DDS
Authorized Official - Phone:252-527-5333
Mailing Address - Street 1:801 PLAZA BLVD
Mailing Address - Street 2:
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28501-2143
Mailing Address - Country:US
Mailing Address - Phone:252-527-5333
Mailing Address - Fax:252-527-1197
Practice Address - Street 1:801 PLAZA BLVD
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28501-2143
Practice Address - Country:US
Practice Address - Phone:252-527-5333
Practice Address - Fax:252-527-1197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-04
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC82231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5904251Medicaid