Provider Demographics
NPI:1811035470
Name:RUNNE, WILLIAM J (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:J
Last Name:RUNNE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4035 MORSAY DR STE 2
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61107-4875
Mailing Address - Country:US
Mailing Address - Phone:815-397-3554
Mailing Address - Fax:815-312-5985
Practice Address - Street 1:4035 MORSAY DR STE 2
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61107-4875
Practice Address - Country:US
Practice Address - Phone:815-397-3554
Practice Address - Fax:815-312-5985
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-0188611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice