Provider Demographics
NPI:1629516919
Name:COLVEN, WILLIAM PRESTON JR (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:PRESTON
Last Name:COLVEN
Suffix:JR
Gender:M
Credentials:DDS, MS
Other - Prefix:DR
Other - First Name:PRESTON
Other - Middle Name:
Other - Last Name:COLVEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS, MS
Mailing Address - Street 1:8355 WALNUT HILL LN STE 125
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4237
Mailing Address - Country:US
Mailing Address - Phone:214-378-8868
Mailing Address - Fax:
Practice Address - Street 1:8355 WALNUT HILL LN STE 125
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4237
Practice Address - Country:US
Practice Address - Phone:214-378-8868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-07
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC124661223P0221X
TX347171223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry