Provider Demographics
NPI:1639483647
Name:HULL, WILLIAM LAWRENCE III (DMD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:LAWRENCE
Last Name:HULL
Suffix:III
Gender:M
Credentials:DMD
Other - Prefix:
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Mailing Address - Street 1:3367 DOUGLAS RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46635-1779
Mailing Address - Country:US
Mailing Address - Phone:574-272-8823
Mailing Address - Fax:574-277-1837
Practice Address - Street 1:3367 DOUGLAS RD
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46635-1779
Practice Address - Country:US
Practice Address - Phone:574-272-8823
Practice Address - Fax:574-277-1837
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-02
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN12013087A1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty