Provider Demographics
NPI:1609303056
Name:DUNLAP, WILLIAM SCOTT
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:SCOTT
Last Name:DUNLAP
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3876 S PARK AVE
Mailing Address - Street 2:
Mailing Address - City:BLASDELL
Mailing Address - State:NY
Mailing Address - Zip Code:14219-1800
Mailing Address - Country:US
Mailing Address - Phone:716-822-2264
Mailing Address - Fax:716-826-3068
Practice Address - Street 1:3876 S PARK AVE
Practice Address - Street 2:
Practice Address - City:BLASDELL
Practice Address - State:NY
Practice Address - Zip Code:14219-1800
Practice Address - Country:US
Practice Address - Phone:716-822-2264
Practice Address - Fax:716-826-3068
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician