Provider Demographics
NPI:1639389828
Name:EVERITT, WILLIAM FRED III (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:FRED
Last Name:EVERITT
Suffix:III
Gender:M
Credentials:DDS
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Mailing Address - Street 1:218 S THOMAS ST
Mailing Address - Street 2:SUITE 122
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38801-5330
Mailing Address - Country:US
Mailing Address - Phone:662-690-5354
Mailing Address - Fax:662-690-5360
Practice Address - Street 1:218 S THOMAS ST
Practice Address - Street 2:SUITE 122
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38801-5330
Practice Address - Country:US
Practice Address - Phone:662-690-5354
Practice Address - Fax:662-690-5360
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MS1820-78 OS-321223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery