Provider Demographics
NPI:1629105093
Name:WILLIAM E GONCE DDS PA
Entity Type:Organization
Organization Name:WILLIAM E GONCE DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:E
Authorized Official - Last Name:GONCE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:302-235-2400
Mailing Address - Street 1:1127 VALLEY RD STE 207
Mailing Address - Street 2:
Mailing Address - City:HOCKESSIN
Mailing Address - State:DE
Mailing Address - Zip Code:19707-8514
Mailing Address - Country:US
Mailing Address - Phone:302-235-2400
Mailing Address - Fax:302-235-2404
Practice Address - Street 1:1127 VALLEY RD STE 207
Practice Address - Street 2:
Practice Address - City:HOCKESSIN
Practice Address - State:DE
Practice Address - Zip Code:19707-8514
Practice Address - Country:US
Practice Address - Phone:302-235-2400
Practice Address - Fax:302-235-2404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEG10001009122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0001062331Medicaid
DE0001061608Medicaid