Provider Demographics
NPI:1750479093
Name:DULEY, WILLIAM PRICE III (DMD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:PRICE
Last Name:DULEY
Suffix:III
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:KY
Mailing Address - Zip Code:40033
Mailing Address - Country:US
Mailing Address - Phone:270-692-3314
Mailing Address - Fax:270-692-2157
Practice Address - Street 1:219 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:KY
Practice Address - Zip Code:40033
Practice Address - Country:US
Practice Address - Phone:270-692-3314
Practice Address - Fax:270-692-2157
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4893122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY60048931Medicaid
KY2398OtherPASSPORT