Provider Demographics
NPI:1710043120
Name:CRESS, BILLY LEE
Entity Type:Individual
Prefix:
First Name:BILLY
Middle Name:LEE
Last Name:CRESS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:BILL
Other - Middle Name:L
Other - Last Name:CRESS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:610 W WHEATLAND RD
Mailing Address - Street 2:
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75116-4518
Mailing Address - Country:US
Mailing Address - Phone:972-296-3292
Mailing Address - Fax:
Practice Address - Street 1:610 W WHEATLAND RD
Practice Address - Street 2:
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75116-4518
Practice Address - Country:US
Practice Address - Phone:972-296-3292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX114831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice