Provider Demographics
NPI:1679614887
Name:MITCHELL, WILLIAM P JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:P
Last Name:MITCHELL
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 297
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22555
Mailing Address - Country:US
Mailing Address - Phone:540-657-8222
Mailing Address - Fax:540-720-9088
Practice Address - Street 1:400 G ST NE
Practice Address - Street 2:SUITE 1
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002
Practice Address - Country:US
Practice Address - Phone:202-546-2233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC3198122300000X
MD6227122300000X
VA8166122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist