Provider Demographics
NPI:1770658858
Name:KIESEL, WILLIAM A (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:A
Last Name:KIESEL
Suffix:
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 1:6 TIMBER BROOK DR
Mailing Address - Street 2:
Mailing Address - City:QUAKERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18951-2654
Mailing Address - Country:US
Mailing Address - Phone:215-538-2913
Mailing Address - Fax:
Practice Address - Street 1:355 EDGEMONT AVE
Practice Address - Street 2:
Practice Address - City:QUAKERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18951-1412
Practice Address - Country:US
Practice Address - Phone:215-536-1717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS021954L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice